Methods, systems, and devices for monitoring and displaying medical parameters for a patient

ABSTRACT

Methods, systems, and devices are provided for monitoring and displaying medical parameters for a patient. In one embodiment, a display can be configured to show a display screen that includes information related to a physiological parameter being measured from a patient. The information can include trends of values of the physiological parameter gathered from the patient over a period of time. The display screen can also show assessment information regarding one or more diagnostic parameters for the patient and notification information regarding one or more medically-related events that occurred as related to the patient. The trends information, the assessment information, and the notification information can be shown on the display screen alone or in any combination.

FIELD

The present disclosure relates generally to methods, systems, anddevices for monitoring and displaying medical parameters for a patient.

BACKGROUND

Patient monitoring can take a variety of forms and can gather a widevariety of physiological data. The display of such data, including whatis displayed and how it is displayed, can affect the ability ofcaregivers, such as doctors and nurses, to interpret and act on thedata. For example, intracranial pressure (ICP) is a standard monitoringmodality for traumatic brain injury patients. Medical guidelines mayprescribe threshold values for intracranial pressure. The guidelines ofthe Brain Trauma Foundation, for example, indicate that clinical actionshould be taken to reduce intracranial pressure if the intracranialpressure exceeds 20-25 mmHg. However, numerous factors can causetransient changes to intracranial pressure, including patientphysiology, monitoring system noise, and actions taken by a caregiver.

To monitor a patient, caregivers typically use monitoring devices suchas the Codman ICP Express device 100, which is shown in FIG. 1,available from Codman & Shurtleff, Inc. of Raynham, Mass. As shown, thedevice 100 has a display of intracranial pressure and a display ofsystolic and diastolic values for the intracranial pressure, as well asan alarm. A caregiver can look at the display to ascertain theintracranial pressure. Caregivers also use charts, e.g., a caregiver canmanually record an event in a chart associated with a patient.

One drawback with current monitoring devices is that the devices onlyprovide a limited amount of patient data. Caregivers thus only have alimited picture of a patient's condition from a monitoring device onwhich to base decision making regarding treatment of the patient. It cantherefore be difficult for caregivers to make clinical decisions basedon the patient data displayed on a monitoring device without takingadditional time to review other patient records, e.g., paper files.Taking this additional time can adversely affect patient treatment,particularly in critical care situations, such as situations involvingtraumatic brain injury patients, where treatment delays can greatlyexacerbate injuries or otherwise be particularly problematic. Moreover,such considerations are applicable not just to intracranial pressure,but to a wide variety of patient monitoring modalities involving otherphysiological parameters.

Accordingly, there remains a need for improved methods, systems, anddevices for monitoring and displaying medical parameters for a patient.

SUMMARY

Methods, systems, and devices are provided for monitoring and displayingmedical parameters for a patient. In one embodiment, a system isprovided that includes a display screen and a processor. The processoris configured to receive a plurality of values for each of a pluralityof physiological parameters measured from a patient over a period oftime and cause a plurality of windows to be displayed on the displayscreen. The plurality of windows include a current value window thatshows a current value for each of the plurality of physiologicalparameters, and a trends window that shows a trendline for each of theplurality of physiological parameters. Each of the trendlines indicatesfor its associated physiological parameter the values of thephysiological parameter over the period of time. The processor is alsoconfigured to cause a time marker to be displayed on the trends window.A position of the time marker relative to each of the trendlinesindicates a selected time within the period of time. The processor isalso configured to cause an assessment window to be displayed on thedisplay screen that indicates a value of each of the plurality ofphysiological parameters at the selected time.

The system can vary in any number of ways. For example, the marker canbe movable simultaneously along each of the trendlines. For anotherexample, the processor can be configured to allow a user to select whichone or more of the plurality of physiological parameters to beconcurrently displayed in the trends window. For yet another example,the processor can be configured to cause a detail trends window to bedisplayed on the display screen in response to a user selecting any oneof the trendlines at the position of the time marker. The detail trendswindow can show a more detailed version of a portion of the selectedtrendline for a second period of time including the selected time. Thesecond period of time can be less than the period of time. For anotherexample, the processor can be configured to display the assessmentwindow concurrently with the trends window on the display screen, or theprocessor can be configured to only display the assessment windowconcurrently with the trends window on the display screen in response toa user input to the processor. For still another example, the processorcan be configured to concurrently display each of the plurality ofwindows on the display screen. For another example, the processor can beconfigured to display a selected one or more of the plurality of windowsat a time. The displayed one or more windows can be user selected fromamong the plurality of windows. For another example, the processor canbe configured to allow a user to repeatedly change a length of theperiod of time. For yet another example, the plurality of windows caninclude a future window that displays projected future values for eachof the physiological parameters values beyond the time period. Theprocessor can be configured to calculate the projected future valuesbased on the measured values.

The plurality of physiological parameters can include at least two ofintracranial pressure (ICP), cerebral perfusion pressure (CPP), meanarterial blood pressure (MAP), oxygen saturation (pO₂), heart rate, andtemperature.

In some embodiments, the processor can be configured to cause anotification marker to be shown on the trends window. The notificationmarker can be disposed at a point within the period of time thatcorresponds to a time at which a medically-related event occurredrelated to the patient. The notification marker can be configured to bemanually input by a user, or the notification marker can be configuredto be automatically added in response to an automatically occurringevent.

In another aspect, a method is provided that in one embodiment includesreceiving a plurality of values for each of a plurality of physiologicalparameters measured from a patient over a period of time and displayinga plurality of windows on a display screen. The plurality of windowsinclude a current value window that shows a current value for each ofthe plurality of physiological parameters, and a trends window thatshows a trendline for each of the plurality of physiological parameters.Each of the trendlines indicates for its associated physiologicalparameter the values of the physiological parameter over the period oftime. The method also includes displaying a time marker on the trendswindow. A position of the time marker relative to each of the trendlinesindicates a selected time within the period of time. The method alsoincludes displaying an assessment window on the display screen thatindicates a value of each of the plurality of physiological parametersat the selected time.

The method can have any number of variations. For example, the markercan be movable simultaneously along each of the trendlines. For anotherexample, the method can include showing a notification marker on thetrends window. The notification marker can be disposed at a point withinthe period of time that corresponds to a time at which amedically-related event occurred related to the patient. Thenotification marker can be configured to be manually input by a user orto be automatically added in response to an automatically occurringevent.

The plurality of physiological parameters can include at least two ofICP, CPP, MAP, pO₂, heart rate, and temperature.

In another aspect, a tangible computer readable medium is provided thathas stored thereon a program. The program can, when executed, performthe method.

BRIEF DESCRIPTION OF DRAWINGS

This invention will be more fully understood from the following detaileddescription taken in conjunction with the accompanying drawings, inwhich:

FIG. 1 (PRIOR ART) is a schematic diagram of a monitoring device;

FIG. 2 is a schematic diagram of one embodiment of a device forproviding a user interface on a display of the device;

FIG. 3 is an embodiment of a trends window of a medical monitoringsystem, the trends window showing trends information over a trendsperiod of time for a plurality of physiological parameters, current dataover a current period of time for the plurality of physiologicalparameters, and assessment information over the trends period of time;

FIG. 4 is an embodiment of a preferences window of the system of FIG. 3;

FIG. 5 shows the trends window of FIG. 3 including trends informationand current data information for a subset of the physiologicalparameters;

FIG. 6 shows the trends window of FIG. 3 including trends informationand current data information for another subset of the physiologicalparameters;

FIG. 7 shows the trends window of FIG. 3 including trends informationand current data information for another subset of the physiologicalparameters;

FIG. 8 shows the trends window of FIG. 3 including trends informationand current data information for yet another subset of the physiologicalparameters;

FIG. 9 shows the trends window of FIG. 3 including trends informationand current data information for another subset of the physiologicalparameters;

FIG. 10 shows the trends window of FIG. 3 for another trends period oftime;

FIG. 11 shows the trends window of FIG. 3 for yet another trends periodof time;

FIG. 12 shows the trends window of FIG. 3 including an acknowledgedalarm for one of the physiological parameters;

FIG. 13 shows the trends window of FIG. 3 including at least one detailtrends window;

FIG. 14 shows the trends window of FIG. 10 including at least one detailtrends window;

FIG. 15 shows the trends window of FIG. 11 including at least one detailtrends window;

FIG. 16 shows the trends window of FIG. 6 including at least one detailtrends window;

FIG. 17 shows the trends window of FIG. 3 including the trendsinformation, the current data over a current period of time for theplurality of physiological parameters, and notification information overthe trends period of time; and

FIG. 18 shows the trends window of FIG. 3 when the medical monitoringsystem is undocked.

DETAILED DESCRIPTION

Certain exemplary embodiments will now be described to provide anoverall understanding of the principles of the structure, function,manufacture, and use of the devices and methods disclosed herein. One ormore examples of these embodiments are illustrated in the accompanyingdrawings. Those skilled in the art will understand that the devices andmethods specifically described herein and illustrated in theaccompanying drawings are non-limiting exemplary embodiments and thatthe scope of the present invention is defined solely by the claims. Thefeatures illustrated or described in connection with one exemplaryembodiment may be combined with the features of other embodiments. Suchmodifications and variations are intended to be included within thescope of the present invention

Further, in the present disclosure, like-numbered components of theembodiments generally have similar features, and thus within aparticular embodiment each feature of each like-numbered component isnot necessarily fully elaborated upon. Additionally, to the extent thatlinear or circular dimensions are used in the description of thedisclosed systems, devices, and methods, such dimensions are notintended to limit the types of shapes that can be used in conjunctionwith such systems, devices, and methods. A person skilled in the artwill recognize that an equivalent to such linear and circular dimensionscan easily be determined for any geometric shape. Sizes and shapes ofthe systems and devices, and the components thereof, can depend at leaston the anatomy of the subject in which the systems and devices will beused, the size and shape of components with which the systems anddevices will be used, and the methods and procedures in which thesystems and devices will be used.

Methods, systems, and devices are provided for monitoring and displayingmedical parameters for a patient. In general, the methods, systems, anddevices can facilitate monitoring of a patient, such as when the patientis being treated at a hospital or other medical facility at which thepatient's condition can require regular observation. The methods,systems, and devices can allow the displaying and monitoring of one ormore physiological parameters of the patient. This monitoring anddisplay can facilitate identification of changes in the patient'scondition that may require a doctor's assessment and/or may require anadjustment of the patient's treatment, e.g., administration ofmedication(s), administration of oxygen, adjustment of one or moresettings of an implanted medical device, adjustment of an elevatedlimb's position, additional hydration, movement to another hospitalunit, etc. Generally, as will be appreciated by a person skilled in theart, the earlier the change in the patient's condition can be detected,the more time medical personnel can have to assess and effectivelyaddress the change. The methods, systems, and devices described hereincan facilitate quick detection and identification of changes in thepatient's condition, thereby facilitating quick, effective treatment ofthe patient.

In one embodiment, a display can be configured to show a display screenthat includes information related to a physiological parameter beingmeasured from a patient. The information can include trends of values ofthe physiological parameter gathered from the patient over a period oftime. The display screen can simultaneously display trends for aplurality of physiological parameters, thereby facilitating comparisonof the parameters and evaluation of the patient's condition. Which ofthe physiological parameters' trends are displayed at the same time onthe display screen can be selectively adjusted, thereby facilitatingcomparison of different parameters with one another. The display screencan also show assessment information regarding one or more diagnosticparameters for the patient and notification information regarding one ormore medically-related events that occurred as related to the patient.The trends information, the assessment information, and the notificationinformation can be shown on the display screen alone or in anycombination. When the assessment information is shown on the displayscreen simultaneously with the trends information, the assessmentinformation and the trends information can each be time-aligned with oneanother on the display screen. This time alignment can facilitateidentification of reasons for any changes in the various trends.Similarly, when the notification information is shown on the displayscreen simultaneously with the trends information, the notificationinformation and the trends information can each be time-aligned with oneanother on the display screen, which can facilitate identification ofreasons for any changes in the various trends.

The physiological parameters can include any one or more variables thatcan be monitored from a patient, as will be appreciated by a personskilled in the art. If a display screen shows current values for aplurality of physiological parameters, the display screen can indicatewhether or not each one of the physiological parameters is within itsown predetermined range, e.g., can trigger an alarm if any one of thephysiological parameters falls outside its associated predeterminedrange. The one or more physiological parameters monitored from a patientcan vary due to one or more factors such as medical context (e.g.,neurological, cardiac, neonatal, etc.), available supplies, doctorpreference, etc. Examples of physiological parameters includeintracranial pressure (ICP), mean arterial blood pressure (MAP),cerebral perfusion pressure (CPP), oxygen saturation (pO₂) (which can beobtained by, e.g., using an invasive oxygen sensor or a pulse oximeter)such as oxygen saturation in brain tissue (PbO2), heart rate,temperature, pressure reactivity index (PRx), pressure-volumecompensatory reserve (RAP) index, fluid pressure in an implantablerestriction device (e.g., a gastric band, etc.), flow rate through animplantable valve (e.g., a cerebral shunt valve, etc.), gastric pHlevel, EEG, tissue impedance, etc. In a neurological context, exemplarymonitored physiological parameters include ICP, CPP, MAP, PbO2, heartrate (HR), and brain temperature (Tb).

The displays described herein can be realized as part of virtually anydevice, e.g., a monitoring device, a personal computer, a workstation, ahandheld computer, a tablet computer, a smartphone, or other computingdevice. The device can include processing circuitry configured toreceive data from one or more sensors configured to gather physiologicaldata from a patient, configured to compare sensor data to storedpredetermined ranges, etc. A wide variety of displays, such as cathoderay tubes (CRTs), liquid crystal display (LCD) screens, touchscreens,etc., can be configured to display screens in response to a signalreceived from the processing circuitry, as a person skilled in the artwill appreciate. Moreover, a wide variety of software packages can beexecuted on the device and/or used to develop the screens and otherelements, including, for example, Flash Macromedia or custom software.

FIG. 2 shows an exemplary embodiment of a device (e.g., a medicalmonitoring device) that can include a display screen configured to showinformation. The device 200 can include one or more displays 202configured to show screens such as those described herein. Thedisplay(s) 202 can be configured to receive signals from processingcircuitry 204, which can include a processor, a video card, and/orvirtually any type of electronic circuitry. The processing circuitry 204can be configured to execute software to draw appropriate screens inresponse to data from one or more input devices 206, e.g., representinguser input, and/or data from one or more sensing devices 208. The inputdevice(s) 206 can include devices configured to provide an input to thedevice 200 such as pointing devices, keyboards, buttons, microphones,soft-keys, touchscreens, etc. The input device(s) 206 can be configuredto be communicatively coupled to the processing circuitry 204 via adevice interface 210. The sensing device(s) 208 can include devicesconfigured to sense and report on a physiological parameter. Examples ofthe sensing device(s) 208 include ICP transducers, temperature sensors,blood pressure monitors, pulse oximeters, evoked potentials, etc. Thesensing device(s) 206 can be configured to be communicatively coupled tothe processing circuitry 204 via a device interface 212. A memory 214can be configured to be coupled to the processing circuitry 204 and beconfigured to store data, such as monitoring software, data from thesensing device(s) 208, predetermined ranges, patient data, etc. Thedevice 200 can include an alarm mechanism 216 configured to providing analarm, e.g., a visual alarm, an auditory alarm, a textual alarm, etc.

In an exemplary embodiment, a housing 218 of the device 200 can house,e.g., have disposed therein and/or have attached thereto, the display(s)202, the memory 214, the alarm 216, the processing circuitry 204, andthe interfaces 210, 212. In this way, the device 200 can be aself-contained unit. The device 200 can thus be portable, wireless,and/or easily connected to wired power supplies in a variety ofdifferent locations. The elements included in the housing 218 can vary.For example, although shown in FIG. 2 as separate devices, e.g., notincluded a housing 218 having the display(s) 202, the memory 214, thealarm 216, the processing circuitry 204, the interfaces 210, 212disposed therein, the input devices 206 and sensing devices 208 can beintegrated into the device 200, e.g., included the hosing 218.Additionally, although the display(s) 202 are shown in FIG. 2 as beingintegrated with the device 200, e.g., attached to the housing 218, oneor more of the display(s) 202 can be separate from the device 200.

FIG. 3 shows an exemplary embodiment of a display screen 300 of amonitoring device configured to display medical information related to apatient. The display screen 300 can generally be configured as a userinterface of a medical monitoring system. The display screen 300 caninclude a plurality of screen type tabs, each of the screen type tabscorresponding to a certain type or arrangement of information related tothe patient. A display screen can be configured to only show one type orarrangement of information related to a patient, in which case thedisplay screen can lack screen type tabs. Each of the screen type tabscan be configured to be selected by a user so as to display the screentype tab's corresponding type or arrangement of information. In theillustrated embodiment, the display screen 300 includes a monitor tab302, a hybrid tab 304, a trends tab 306, and a future tab 308, but thedisplay screen 300 can include more or less than four tabs. The trendstab 306 is selected in FIG. 3 so as to show a trends window 310 on thedisplay screen 300. The monitor, hybrid, and future tabs 302, 304, 308can each be selected so as to show, respectively, a hybrid window, atrends window, and a future window on the display screen 300, asdiscussed further below.

The display screen 300 can include a wide variety of other features anddisplay a wide variety of other data. The display screen 300 can includeone or more static features configured to be on the display screen 300regardless of which of the tabs 302, 304, 306, 308 is currentlyselected. For example, the display screen 300 can include any one ormore of a patient ID window 354 that identifies the patient (e.g., byname, number, code, etc.); a help button 356 configured to beuser-activated so as to provide technical assistance (e.g., access to auser manual, ability to search Frequently Asked Questions, etc.); a sortbutton 358 configured to be user-activated so as to allow reordering ofparameters shown on the currently displayed window (which is the trendswindow 310 in FIG. 3), which can be advantageous for comparing differentselected ones of the parameters; a history button 360 configured to beuser-activated so as to provide historical sensed data for the patientand/or other patient records; a print button 364 configured to beuser-activated so as to provide the ability to print the currentlydisplayed window or portion(s) thereof (e.g., print to an attachedprinter or a printer integrated into the medical monitoring device); acurrent date/time indicator 366; a power connector 368 that indicateswhether or not the device is connected to external electrical power; acharge indicator 370 that indicates a current charge of a batteryincluded in the monitoring device; a docking indicator 372 thatindicates whether or not the device is docked at a docking station(e.g., a bedside docking station, etc.); etc. Embodiments of providinghistorical sensed data and embodiments of marking events are describedin further detail in U.S. Pat. Pub. No. 2009/0005703 entitled “MedicalMonitor User Interface” filed Jun. 27, 2007, which is herebyincorporated by reference in its entirety. One or more static featuresmay only be shown on the trends window 310 in response to a triggerevent, such as the charge indicator 370 being configured to appear onlywhen the battery charge is low.

The relative sizes and locations of the various windows, symbols, text,icons, etc. of the trends window 310, and for other windows that can beshown on the display screen 300, are exemplary in nature. A personskilled in the art will appreciate that any of the various windows,symbols, text, icons, etc. of the display screen 300 can have virtuallyany size and virtually any location.

The current data window 312 can be configured to show currentinformation for one or more physiological parameters. In the illustratedembodiment, the current data window 312 shows current information forICP, MAP/BP, HR, external ventricular drainage (EVD) ICP (e.g., an ICPmeasurement performed with an external fluid coupled sensor that isconnected to the EVD system) variously shown as “ICP 2” and “EVD,” CPP,PbO2, and Tb, but as mentioned above, any one or more parameters can bemonitored and/or calculated, and information for any one or more typesof current values based on the physiological parameters can be shown onthe current data window 312. The current information displayed for eachof the physiological parameters can be based on data received by themonitoring device in any of a variety of ways, as will be appreciated bya person skilled in the art, e.g., via a Codman Microsensor ICPTransducer (available from Codman & Shurtleff, Inc. of Raynham, Mass.),via an Integra Camino® ICP Transducer (available from IntegraLifeSciences Corporation of Plainsboro, N.J.), via a blood pressuremonitor, via a temperature sensor attached to the patient, etc.

For each of the physiological parameters, the current data window 312can be configured to show a textual display of current parameterinformation and/or a graphical display of current parameter information.In the illustrated embodiment, the current data window 312 includes anICP textual display 314, a MAP/BP textual display 316, an HR textualdisplay 318, a textual display 322 for EVD ICP, a textual display 326for CPP, a textual display 328 for pbO2, and a textual display 330 forTb. Which one or more of the physiological parameters have a textualdisplay only, have a graphical display only, or have both a textualdisplay and a graphical display can be user-adjusted, such as bydragging and dropping displays on the touchscreen.

The textual display of current information for each physiologicalparameter can include numerical data regarding the physiologicalparameter for a current time period, and the graphical display for eachphysiological parameter can include a graphical illustration of thenumerical data for the current time period. The current time period canbe a predetermined amount of time that can be a default, preprogrammedtime period, e.g., preprogrammed into a processor, or can be customizedfor a particular patient. The current time period can be, e.g., in arange of about five to sixty seconds, in a range of about five to tenseconds, a single heartbeat, the most recent few heartbeats of thepatient, etc. The current time period can be adjustable. In someembodiments, to receive user input of this nature, the medicalmonitoring device can include or be configured to couple to an inputdevice, such as a touchscreen, keypad, touchpad, pointing device, mouse,button, knob, dial, etc. The display screen 300 can include atouchscreen configured to allow the current time period to be adjustedwhen, e.g., a user activates a main menu button, activates one of thetextual displays included in the current data window 312 as discussedfurther below, etc. Adjustment of the current time period can allow forvarious clinical protocols, as such protocols that can require trackingof a parameter over different time periods. Trend time periods, futuretime periods, normal ranges, and goal ranges for the variousphysiological parameters, discussed further below, can be similarlyadjusted.

For ease of discussion, the textual display 314 for ICP is discussedbelow as a representative example of a textual display for aphysiological parameter shown in the current data window 312. Textualdisplays for other physiological parameters shown in the current datawindow 312 can be similarly configured. Additionally, ICP is shown inthe current data window 312 in units of mmHg, but ICP can be displayedon any window in any appropriate unit. Similarly, other physiologicalparameters can be displayed in any appropriate units.

The textual display 314 can represent ICP textually and/or pictorially.In the illustrated embodiment, the textual display 314 includes acurrent value based on the received ICP values. The current valueincludes an average of ICP values gathered during the current timeperiod including a current average (e.g., the current averageintracranial pressure) and a goal range for the current average.Examples of current values include an average of gathered values, anaverage of a calculated index (e.g., an average of peak gathered values,an average of a rate of change of the gathered values, etc.), a medianof gathered values, a rate of change of gathered values, a correlation(e.g., PRx, pressureRAP index, autocorrelation, an average ofautocorrelation, etc.), a maximum value among the gathered values, aminimum value among the gathered values, a root mean square (RMS),peak-to-peak values, etc. Various embodiments of displaying currentinformation related to physiological parameters are discussed in furtherdetail in U.S. application Ser. No. 13/803,667 entitled “Methods,Systems, And Devices For Monitoring And Displaying Medical ParametersFor A Patient” filed on Mar. 14, 2013, which is hereby incorporated byreference in its entirety.

The current value can be shown textually and/or graphically. In theillustrated embodiment, the current average is shown textually with anumerical value 334. The average ICP value in the illustrated embodimentis 10 mmHg. As will be appreciated by a person skilled in the art, thenumerical value 334 shown on the trends window 310 can be an exactaverage value or can be a rounded value, e.g., rounded to a nearestwhole number (as in the illustrated embodiment), rounded to one decimalplace, rounded to two decimal places, etc.

The goal range can be shown textually and/or graphically. In theillustrated embodiment, the goal range is shown textually with an uppergoal limit that corresponds to a predetermined upper limit of the goalrange and with a lower goal limit that corresponds to a predeterminedlower limit of the goal range. By way of example, a predetermined goalrange for ICP can be about 5 to 15 mmHg, a predetermined goal range forCPP can be about 70 to 90 mmHg, a predetermined goal range for Tb can beabout 36.5 to 37.1° C., and a predetermined goal range for MAP can beabout 80 to 100 mmHg. In the illustrated embodiment, the upper goallimit for ICP is 14 mmHg, and the lower goal limit for ICP is 8 mmHg;the upper goal limit for MAP/BP is 125 mmHg, and the lower goal limitfor MAP/BP is 98 mmHg; and the upper goal limit for EVD ICP is 19 mmHg,and the lower goal limit for EVD ICP is 8 mmHg. Goal ranges may not bedisplayed for one or more physiological parameters, such as if goalranges have not yet been input for those parameter(s). Variousembodiments of goal ranges for physiological parameters are discussed infurther detail in U.S. application Ser. No. 13/803,667 entitled“Methods, Systems, And Devices For Monitoring And Displaying MedicalParameters For A Patient” filed on Mar. 14, 2013.

The current data window 312 can include a menu feature configured tofacilitate changing system preferences such as time period adjustments,whether to show textual and/or graphical displays for a particularlyphysiological parameter, to adjust a predetermined normal range for aparticular physiological parameter, to start or stop data collectionfrom a sensing device associated with a physiological parameter, etc. Byway of example, a typical normal range for ICP is about 0 to 20 mmHg, atypical normal range for CPP is about 50 to 150 mmHg, a typical normalrange for Tb is about 36 to 37.5° C., and a typical normal range for MAPis about 70 to 110 mmHg. In one embodiment, the menu feature can includea menu button (not shown) configured to be user-activated, e.g., touchedon a touchscreen, clicked on using a pointing device, etc. In anotherembodiment, each of the textual displays 314, 316, 318, 322, 326, 328,330 for ICP, MAP/BP, HR, EVD ICP, CPP, pbO2, and Tb, respectively, canbe configured as a user-selectable button, e.g., a button configured tobe user-activated. Selecting one of the textual displays 314, 316, 318,322, 326, 328, 330 in the current data window 312 can cause apreferences window to appear for the physiological parameter associatedwith the selected one of the textual displays 314, 316, 318, 322, 326,328, 330.

FIG. 4 shows an embodiment of a preferences window 313 that can beconfigured to appear upon selection of one of the textual displays 314,316, 318, 322, 326, 328, 330 in the current data window 312. In thisillustrated example, the textual display 314 for ICP has been selected.The preferences window 313 can have a variety of configurations tofacilitate changing various settings, as will be appreciated by a personskilled in the art. For example, various changeable settings (not shown)can appear in a body 315 of the preferences window 313 using any one ormore preference settings mechanisms, e.g., text entry fields, selectableradio buttons, check boxes, etc.

Referring again to FIG. 3, the trends window 310 can be configured toshow information for one or more physiological parameters in a trendtime period. In an exemplary embodiment, the trend time period can belonger than the current time period, e.g., fifteen minutes, thirtyminutes, ninety minutes, one hundred minutes, etc., although virtuallyany time period can be used as the trend time period. In someembodiments, the trend time period can be hours, days, or longer. Thetrend time period can entirely precede the current time period or canoverlap at least partially with the current time period. In someembodiments, the trend time period can correspond to requirements of aparticular physiological parameter. For example, the trend time periodcan correspond to a time period pertinent to ICP monitoring and therebyallow a caregiver to review this trend time period. Similar to thatdiscussed above regarding the current time period, the trend time periodcan be a predetermined amount of time that can be a default,preprogrammed time period, e.g., preprogrammed into a processor, or canbe customized for a particular patient.

The trend time period can be adjustable similar to that discussed abovewith respect to the current time period. The display screen 300 caninclude a trend time adjustment mechanism configured to facilitate userselection of a predetermined trend time period. In one embodiment, thetrends window 310 can include a trend preferences button (not shown)configured to be activated to allow selection of the trend time period,such as by providing a preferences window in which different trend timeperiods can be selected. As in the illustrated embodiment, the trendtime adjustment mechanism can include a trend time window 311 that beconfigured to include a plurality of selectable trend time buttons 332a, 332 b, 332 c, 332 d, 332 e, 332 f, 332 g. The trend time window 311can be included as part of the trends window 306, as in the illustratedembodiment. The trend time window 311 can also include a detail timeperiod button 336 configured to allow selection of a detail time period,discussed further below.

Each of the trend time buttons 332 a, 332 b, 332 c, 332 d, 332 e, 332 f,332 g can be configured to be user selected, such as when the displayscreen 300 is a touchscreen configured to allow a user to activate aselected one of trend time buttons 332 a, 332 b, 332 c, 332 d, 332 e,332 f, 332 g by touching the selected button. In the illustratedembodiment, an “8 hr” trend time button 332 d is selected such that thetrend time period in the embodiment of FIG. 3 is eight hours. Thecurrently-selected trend time period can be identified on the trendwindow 310, such as by highlighting a selected one of the trend timebuttons 332 a, 332 b, 332 c, 332 d, 332 e, 332 f, 332 g, as in theillustrated embodiment in which the selected “8 hr” button 332 d is adifferent color than a remainder of the trend time buttons 332 a, 332 b,332 c, 332 e, 332 f, 332 g. In another embodiment, thecurrently-selected trend time period can be displayed by showing onlythe one of the trend time buttons 332 a, 332 b, 332 c, 332 d, 332 e, 332f, 332 g associated with the currently-selected trend time period, byproviding text identifying the currently-selected trend time window,and/or otherwise identifying the currently-selected trend time window. Areminder of the trend time buttons 332 a, 332 b, 332 c, 332 e, 332 f,332 g can be configured to appear in response to selecting a preferencesmenu (not shown) within the trend time window 311 and/or elsewhere onthe display screen 300 so as to allow changing of the currently-selectedtrend time window.

Instead of including a plurality of trend time periods in the form ofselectable buttons, e.g., the trend time buttons 332 a, 332 b, 332 c,332 d, 332 e, 332 f, 332 g, from which a user can select a trend timeperiod to be used for the displayed parameter information, the trendtime window 311 can additionally or alternatively include another trendtime adjustment mechanism. For example, the trend time window 311 caninclude a trend time adjustment mechanism in the form of a text entryfield configured to allow user input of text thereto, the input textidentifying the trend time window, e.g., user text entry of “1” for atrend time window of one hour, user entry of “2” for a trend time windowof two hours, etc. For another example, the trend time adjustmentmechanism can include a slidable bar configured to be slid along atimeline having one end define an upper limit of the trend time periodand the other end define a lower limit of the trend time period. Aselected position of the slidable bar along the timeline can indicatethe trend time period. For another example, the trend time adjustmentmechanism can include a zoom in/zoom out feature of a capacitivetouchscreen. Zooming in, e.g., by a user making a zoom-in or pinch touchgesture on the touchscreen, can shorten the trend time period, andzooming out, e.g., e.g., by a user making a zoom-out or spread touchgesture on the touchscreen, can lengthen the trend time period.

The trend time period can be selectively adjustable in length, such asby selecting different ones of the buttons trend time buttons 332 a, 332b, 332 c, 332 d, 332 e, 332 f, 332 g. In an exemplary embodiment, thetrends window 310 can be configured to have selectively adjustable startand end dates and times for the selected trend time period. Adjustingthe start and end dates and times of the selected trend time period canfacilitate diagnosis, assessment, and/or treatment of the patient byallowing different periods of time to be viewed and/or analyzed. Thestart and end dates and times can be adjusted in a variety of ways. Inone embodiment, the trends window 310 can include a text entry field(not shown) configured to allow user input of start and end dates andtimes of the selected trend time period. In another embodiment, thetrends window 310 can include a calendar feature configured to allow auser to scroll through dates and times to select specific start and enddates and times of the selected trend time period. In yet anotherembodiment, the trends window 310 can include a trend preferences button(not shown) configured to be activated to allow adjustment of start andend dates and times of the trend time period, such as by providing apreferences window in which start and end dates and times of the trendtime period can be selected. As in the illustrated embodiment, atimeline 307 can be configured to allow selection of start and end datesand times thereof. The selection can be provided in any number of ways,such as in the illustrated embodiment where a forward button 307 f and aback button 307 b are provided. The forward button 307 f can beconfigured to be activated to scroll forward in time to adjust the trendtime period forward. Similarly, the back button 307 b can be configuredto be activated to scroll back in time to adjust the trend time periodbackward. One or both of the back and forward buttons 307 b, 307 f canbe configured to initially scroll at a first speed through time and beconfigured to scroll at a second, faster speed if held down for apredetermined amount of time, e.g., at least two seconds, at least threeseconds, etc., or otherwise activated for fast scrolling, e.g., doubleclicked instead of single clicked.

The graphical displays of the trends window 310 can be configured toautomatically update to reflect changed start and end dates and times ofthe trend time period. In other words, trendlines in the graphicaldisplays can be configured to dynamically change to reflect valuesbetween the currently selected start and end of the trend time period.The trendlines can thus be time aligned with the start and end dates andtimes of the time period. Thus, in the illustrated embodiment,activation of the back button 307 b can cause the trendlines 348 t, 352t, 374 t, 376 t to dynamically update and each reflect an earlierdate/time, and activation of the forward button 307 f can cause thetrendlines 348 t, 352 t, 374 t, 376 t to dynamically update and eachreflect a later date/time.

In the illustrated embodiment, the trends window 310 is configured toshow information for ICP, MAP, EVD ICP, CPP, HR, PbO2, and Tb, but asmentioned above, any one or more physiological parameters can bemonitored and displayed, and information for any one or morephysiological parameters can be shown on the trends window 310. Theinformation displayed for each of the physiological parameters can bebased on data received by the monitoring device in any of a variety ofways, as mentioned above.

For each of the physiological parameters, the trends window 310 can beconfigured to show a textual display of parameter information for thetrend time period and/or a graphical display of parameter informationfor the trend time period. The textual display and/or the graphicaldisplay for each of the physiological parameters ICP, MAP/BP and HR, EVDlevel, CPP, PbO2, and Tb shown on the trends window 310 can beconfigured to be observed by a user, e.g., viewed on the screen 300, soas to assess the patient's condition. In the illustrated embodiment, thetrends window 310 includes a textual display 346 and a graphical display348 for ICP, a textual display 350 and a graphical display 352 forMAP/BP, a textual display 354 and a graphical display 374 for EVD ICP, atextual display 376 and a graphical display 378 for CPP, a textualdisplay 380 for pbO2, a textual display 382 for Tb, and a textualdisplay 384 for HR. Which one or more of the physiological parametershave a textual display only, have a graphical display only, or have botha textual display and a graphical display can be user-adjusted, such asby dragging and dropping displays on the touchscreen, activating a menubutton, actuating one of the textual displays in the current data window312, etc. Graphical displays for one or more of the physiologicalparameters can be hidden due to one or more factors such as a desire tomaximize a size of shown graphical displays, a large number ofphysiological parameters, space limitations on the display screen 300,etc. In the embodiment illustrated in FIG. 3, graphical displays arehidden for PbO2, Tb, and HR, which do have textual displays 380, 382,384 on the trends window 310. In an exemplary embodiment, graphicaldisplays can be configured to automatically hidden based on apredetermined number of graphical displays that can be shown on thetrends window 310 at a time. The predetermined number of graphicaldisplays is three in the illustrated embodiment, but any number one orgreater is possible. The predetermined number of graphical displays canbe a user-adjustable number, e.g., by selecting a menu button. Thepredetermined number of graphical displays can be based on any one ormore factors, such as a screen size, screen resolution, etc.

Hidden graphical display(s) can be accessed in a variety of ways. In anexemplary embodiment, the trends window 310 can include a scrollelement, e.g., a scroll button, a text selection menu, a slidable scrollbar, etc., configured to allow scrolling through the physiologicalparameters to allow hidden graphical displays to be viewed on the trendswindow 310. The scroll element in the illustrated embodiment includes atouch-activated scroll button 386 and at least one arrow includedtherein and/or adjacent thereto that indicates a direction available forscrolling. In the illustrated embodiment, an arrow 386 a included in thebutton 386 and another arrow 386 b adjacent the button 386 point downbecause the three hidden parameters are ordered below the threenon-hidden parameters. As discussed further below, order of theparameters can be adjusted. The scroll button 386 can include downarrow(s) only, up arrow(s) only, or both up and down arrows based onwhere hidden parameters are located in the order of parameters. If allparameters are shown on the trends window 310, e.g., if no parameters'graphical displays are hidden, the trends window 310 can lack a scrollelement.

In some instances, data may not be received for a certain physiologicalparameter, such as if a sensing device for the certain physiologicalparameter is not attached to the patient or if a sensing device for thecertain physiological parameter attached to a patient has not beenelectronically connected to a processor that processes data to bedisplayed on the display screen 300. If data is not received for one ormore physiological parameters, textual and graphical display(s) forthose one or more physiological parameters can be absent from thedisplay screen 300. Both the textual display(s) and the graphicaldisplay(s) for those one or more physiological parameters can be presenton the current data window 312 and/or the currently selected window,which is the trends window 310 in FIG. 3, but lack any numerical orgraphed data, or one of the graphical display(s) and textual display(s)for those one or more physiological parameters can be absent from thecurrent data window 312 and/or the trends window 310 while the other ofthe graphical display(s) and textual display(s) for those one or morephysiological parameters can be present on the current data window 312and/or the trends window 310. By having at least one of the textualdisplay(s) and the graphical display(s) for those one or more parameterspresent on the current data window 312 and/or the trends window 310, itcan be easier for a user observing the current data window 312 and/orthe trends window 310 to determine, based on a lack of data in thosegraphical and/or textual display(s), that those one or more parametersare not being monitored or that the sensing device(s) for those one ormore parameters are not properly configured. The present textual and/orgraphical display(s) for those one or more parameters can each includeat least one data absence indicator, e.g., a textual message, a warningsymbol, etc., indicating that data is not being received.

FIG. 5 shows an example of the display screen 300 in which data is beingreceived for a plurality of physiological parameters, e.g., ICP, MAP/BP,and CPP, and is not being received for another plurality ofphysiological parameters, e.g., EVD ICP, PbO2, and Tb. The displayscreen 300 in this illustrated embodiment thus lacks textual andgraphical displays for EVD ICP, PbO2, and Tb in the trends window 310and lacks any numerical data in the textual displays 322, 328, 330 inthe current data window 312 for EVD ICP, PbO2, and Tb. In theillustrated embodiment, the textual displays 322, 328, 330 in thecurrent data window 312 for EVD ICP, PbO2, and Tb each include a dataabsence indicator in the form of a textual message, “Not connected” inthe EVD ICP and Tb displays 322, 330 and “Not installed” in the PbO2display 328. FIG. 5 also shows an example of a scroll element beingunnecessary because all graphical displays 348, 352, 378 for “active”parameters are shown on the trends window 310. The scroll button 386 isthus grayed out in FIG. 5, thereby indicating that the scroll button 386cannot be actuated even if touched on the touchscreen.

FIG. 6 shows an example of the display screen 300 in which data is beingreceived for a single physiological parameter, e.g., ICP, and is notbeing received for a plurality of physiological parameters, e.g., MAP/BPand HR, CPP, EVD ICP, PbO2, and Tb. The display screen 300 in thisillustrated embodiment thus lacks textual and graphical displays forMAP/BP and HR, CPP, EVD ICP, PbO2, and Tb in the trends window 310 andlacks any numerical data in the textual displays 318, 322, 326, 328, 330in the current data window 312 for MAP/BP and HR, CPP, EVD ICP, PbO2,and Tb. In the illustrated embodiment, the textual displays 318, 322,326, 328, 330 in the current data window 312 for MAP/BP and HR, CPP, EVDICP, PbO2, and Tb each include a data absence indicator in the form of atextual message, “Not connected” in the MAP/BP and HR, EVD ICP, CPP, andTb displays 318, 322, 326, 330 and “Not installed” in the PbO2 display328. FIG. 6 also shows an example of a scroll element being unnecessarybecause all graphical displays 348 for “active” parameters are shown onthe trends window 310. The scroll button 386 is thus grayed out in FIG.6, thereby indicating that the scroll button 386 cannot be actuated evenif touched on the touchscreen.

FIG. 7 shows an example of the display screen 300 in which data is beingreceived for a plurality of physiological parameters, e.g., ICP, MAP/BPand HR, EVD ICP, and CPP, and is not being received for a plurality ofphysiological parameters, e.g., PbO2 and Tb. The display screen 300 inthis illustrated embodiment thus lacks textual and graphical displaysfor PbO2 and Tb in the trends window 310 and lacks any numerical data inthe textual displays 328, 330 in the current data window 312 for PbO2and Tb. In the illustrated embodiment, the textual display 328, 330 inthe current data window 312 for Tb includes a data absence indicator inthe form of a textual message, “Not connected” in the Tb display 330 and“Not installed” in the PbO2 display 328. FIG. 7 also shows an example ofthe scroll button 386 being actuatable to scroll down for at least oneadditional graphical trends display, e.g., a graphical display for HR.

FIG. 8 shows yet another example of the display screen 300 in which datais being received for a plurality of physiological parameters, e.g.,ICP, MAP/BP and HR, EVD ICP, and CPP, and is not being received for aplurality of physiological parameters, e.g., PbO2 and Tb. The displayscreen 300 in this illustrated embodiment thus lacks textual andgraphical displays for PbO2 and Tb in the trends window 310 and lacksany numerical data in the textual displays 328, 330 in the current datawindow 312 for PbO2 and Tb. In the illustrated embodiment, the textualdisplay 328, 330 in the current data window 312 for Tb includes a dataabsence indicator in the form of a textual message, “Not connected” inthe Tb display 330 and “Not installed” in the PbO2 display 328. FIG. 8also shows an example of the scroll button 386 being actuatable toscroll up for at least one additional graphical trends display, e.g., agraphical display for MAP/BP, CPP, and EVD ICP, that are currentlyhidden while graphical displays 348, 388 are shown for ICP and HR.

While FIG. 8 has available graphical displays 348, 352, 374, 378, 388for the same parameters ICP, MAP/BP, EVD ICP, CPP, and HR as in FIG. 7,the parameters are in different orders in FIGS. 7 and 8 such thatdifferent graphical displays are shown in FIGS. 7 and 8. Moreparticularly, the parameters are ordered from top to bottom in FIG. 7 asICP, MAP/BP, EVD ICP, CPP, and HR, while the parameters are ordered fromtop to bottom in FIG. 8 as MAP/BP, CPP, EVD ICP, ICP, and HR. Asmentioned above, ordering of parameters can be adjusted, such as tofacilitate comparison of two or more parameters by arranging graphicaldisplays for those two or more parameters to be adjacent to one anotheron the trends window 310. Selection of the sort button 358 can allow forreordering of parameters, as mentioned above. Selecting the sort button358 can, for example, provide on the screen 300 a list of availableparameters in their current order. One or more parameters can be draggedand dropped to new places within the list so as to reorder theparameters.

One or more parameters can be frozen at a top of the parameter order,which can facilitate comparison of the frozen parameter(s) with each ofthe other parameters as the other parameters scroll on/off the trendswindow 310. Selecting the sort button 358 can allow the frozenparameter(s) to be chosen. Similarly, any frozen parameter(s) can beunfrozen, such as by selecting the sort button 358.

FIG. 9 illustrates an example of the trends window 310 including atleast one frozen parameter, which includes ICP in this illustratedexample. The frozen parameter can identified as being frozen on thedisplay screen 300 in any one or more ways, such as by being indicatedwith a text identifier, e.g., “Frozen,” in the frozen parameter'stextual display and/or graphical display, with background shading of thefrozen parameter's textual display and/or graphical display (as in theillustrated embodiment in which the ICP textual and graphical displays346, 348 have a different background color (a lighter shade of grey inthe illustrated embodiment) than the other textual displays 380, 382,384 and graphical displays 390, 392, 388 for PbO2, Tb, and HR, byshowing a divider line 381 between frozen display(s) and non-frozendisplay(s), etc. FIG. 9 also shows an example of the scroll button 386being actuatable to scroll up for at least one additional graphicaltrends display, e.g., a graphical display for MAP/BP, CPP, and EVD ICP,that are currently hidden while graphical displays 348, 390, 392, 388are shown for ICP, PbO2, Tb and HR.

Referring again to FIG. 3, the textual display for each physiologicalparameter can include numerical data regarding the physiologicalparameter for the trend time period, and the graphical display for eachphysiological parameter can include a graphical illustration of thenumerical data for the trend time period. For ease of discussion, thetextual display 314 and the graphical display 348 for ICP are discussedbelow as representative examples of textual and graphical displays for aphysiological parameter shown on the trends window 310. Textual andgraphical displays for other physiological parameters shown on thetrends window 310 can be similarly configured.

The graphical display 348 can represent ICP graphically with a trendline348 t, in the form of a waveform or graph line, plotted over the trendtime period, e.g., the trend time selected via one of the selectabletrend time buttons 332 a, 332 b, 332 c, 332 d, 332 e, 332 f, 332 g.However, virtually any graphical representation can be used, such as agraph line, a bar graph, a plot of discrete data points, and/or otherpictorial display. The graphical display 348 in the illustratedembodiment plots via the trendline 348 t ICP values gathered and/orcalculated during the trend time period, which as mentioned above iseight hours in the illustrated embodiment. Similarly, the trends window310 shows trendlines 352 t, 374 t, 376 t in the other graphical displays352, 374, 376 spanning eight hours. The graphical display 348 can show(e.g., via a graph line and/or other pictorial display) values ofanother statistic based on ICP, e.g., a mean value of the physiologicalparameter calculated over a sample period, e.g., every two to threeseconds, a median value, a normalized value, a systolic value, adiastolic value, wave amplitude, etc. In an exemplary embodiment, if thetrends window 310 shows information for a plurality of physiologicalparameters, as in the illustrated embodiment, the same statistic(s) areshown on the trends window's graphical displays for each of theparameters, thereby facilitating quick identification and understandingof the displayed information.

FIGS. 10 and 11 illustrate embodiments in which the ICP trendline 348 tis shown over trend time periods other than eight hours. FIG. 10illustrates an embodiment in which a one hour trend time period isselected, e.g., by selection of the “1 hr” trend time button 332 f, suchthat the trendline 348 t shows the current value (e.g., average ICP)over a one hour time period and similarly shows the trendlines 352 t,374 t, 376 t in the other graphical displays 352, 374, 376 spanning onehour. FIG. 11 illustrates an embodiment in which a forty-eight hourtrend time period is selected, e.g., by selection of the “48 hr” trendtime button 332 a, such that the trendline 348 t shows the current value(e.g., average ICP) over a forty-eight hour time period and similarlyshows the trendlines 352 t, 374 t, 376 t in the other graphical displays352, 374, 376 spanning forty-eight hours.

Referring again to FIG. 3, the textual display 346 can represent ICPtextually and/or pictorially. In the illustrated embodiment, the textualdisplay 346 includes information related to an average of ICP valuesgathered and/or calculated during the trend time period including acurrent average (e.g., the current average intracranial pressure) overthe trend time period. Although a current value related to ICP is anaverage of gathered values in the illustrated embodiment, as mentionedabove, other current values can be shown instead of or in addition tothe average of gathered values, e.g., an average of a calculated index(e.g., an average of peak gathered values, an average of a rate ofchange of the gathered values, etc.), a median of gathered values, arate of change of gathered values, a correlation (e.g., PRx, RAP,autocorrelation, an average of autocorrelation, etc.), a maximum valueamong the gathered values, a minimum value among the gathered values, aroot mean square (RMS), peak-to-peak values, etc.

The current value can be shown textually and/or graphically. In theillustrated embodiment, the current average is shown textually with anumerical value 347. The average ICP value in the illustrated embodimentis 12 mmHg. As will be appreciated by a person skilled in the art, thenumerical value 337 shown on the trends window 310 can be an exactaverage value or can be a rounded value, e.g., rounded to a nearestwhole number (as in the illustrated embodiment), rounded to one decimalplace, rounded to two decimal places, etc. The numerical value 347 shownfor ICP in the textual display 346 of the trends window 310 can bedifferent than the numerical value 334 in the current data window 312,as in the illustrated embodiment, since the numerical value 347 shownfor ICP in the textual display 346 of the trends window 310 is based onthe trend time period, whereas the numerical value 334 in the currentdata window 312 is based on the current time period. In an exemplaryembodiment, the numerical values 334, 347 are of a same type of currentvalue, e.g., both averages of gathered values, so as to facilitatecomparison of the physiological parameter over different time periods.

The textual displays and/or the graphical displays for any one or moreof the physiological parameters shown in the trends window 310 and/or inthe current data window 312 can include other information regardingtheir respective physiological parameters. For example, still using ICPas a representative example, the textual display 314 in the current datawindow 312 can include a sensing device position indicator (not shown)that indicates a position (e.g., (L/R parenchyma, L/R ventricle, orlumbar) of a sensing device (not shown) sensing ICP from the patient soas to gather ICP values therefrom. The position can be entered manually.For another example, the textual display 354 and/or the graphicaldisplay 374 for EVD ICP can indicate textually and/or graphicallywhether or not the EVD having the EVD ICP is an open state or a closedstate. As will be appreciated by a person skilled in the art, a defaultstate of an EVD is typically the closed state. The EVD being in theclosed state can be indicated by, e.g., not providing any particulartextual or graphical indication regarding the EVD's open or closedstate. FIG. 3 illustrates an embodiment in which the EVD is indicated asbeing in the open state, e.g., that the EVD opened to relieve excesscerebral spinal fluid (CSF) in the brain. The open state is indicated inthe FIG. 3 embodiment with a textual EVD state indicator 355 (“Open”) inthe EVD textual display 354 and a graphical EVD state indicator in theform of background shading in the EVD graphical display 374. The textualEVD state indicator 355 can have another configuration (e.g., “openstate,” “EVD open,” “closed,” “EVD closed,” etc.), and the graphical EVDstate indicator can also have other configurations (e.g., a schematicillustration of an open EVD device, etc.)

To facilitate assessment of the patient's condition, an alarm, e.g., anaudible sound, a flashing window, an illuminated light, a color changeon the display screen 300, a page to an attending physician, etc., canbe provided if any of the monitored physiological parameters falloutside their associated normal range. The alarm can be provided in avariety of ways. In an exemplary embodiment, when a current value of oneof the physiological parameters, e.g., ICP, MAP/BP, HR, EVD level, CPP,PbO2, and Tb, shown on the trends window 310 (e.g., in any of thecurrent data window 312, the textual displays 346, 350, 354, 376, 380,382, 384, and the graphical displays 348, 352, 374, 378) falls outsideits associated predetermined normal range, the alarm can be triggered.In other words, when a current value of one of the physiologicalparameters increases to be above the predetermined upper normal limitfor that physiological parameter or decreases to be below thepredetermined lower normal limit for that physiological parameter, thealarm can be triggered. In other words, when the physiologicalparameter's average falls outside the normal range as determined by thedevice's processor, the processor can cause the device's alarm toactivate. An alarm may exist for a parameter in only one of the currentdata window 312 and the parameter's associated textual and graphicaldisplays because of the differing time periods used in the current datawindow 312 and the parameter's associated textual and graphicaldisplays. Various embodiments of providing alarms for physiologicalparameters are discussed in further detail in U.S. application Ser. No.13/803,667 entitled “Methods, Systems, And Devices For Monitoring AndDisplaying Medical Parameters For A Patient” filed on Mar. 14, 2013.

In the illustrated embodiment of FIG. 3, the ICP, MAP/BP, HR, ICP 2,CPP, PbO2, and Tb physiological parameters are within their respectivenormal ranges such that alarms are not shown for any of MAP/BP, HR, ICP2, CPP, PbO2, and Tb. Any one or more of the parameters on the screen300 can, in any combination thereof, have alarms therefor.

When an alarm is triggered, the alarm can persist, e.g., a sound cancontinue sounding, the textual display's background color can remain itschanged color, the textual display's background color can flash, awarning light attached to the display can continue flashing, etc., untilthe alarm is acknowledged by a user and/or until the out-of-normal rangeparameter's average falls back within the normal range. The alarm can beacknowledged in a variety of ways, such as by activating an alarmsilence button (not shown). In an exemplary embodiment, the alarmsilence button can appear only when an alarm is triggered.

When the alarm is acknowledged, the display screen 300 can continue toindicate that the out-of-normal-range parameter is outside the normalrange until the parameter returns to within the normal range. In thisway, the display screen 300 can indicate that the alarm condition hasbeen observed by at least one medical practitioner, e.g., nurse, doctor,etc. Thus, any subsequent observer of the display screen 300 while thealarm condition persists can determine from the display screen 300 thatthe alarm has been previously observed and is likely being tended to asneeded. The display screen 300 can display an acknowledged alarm in avariety of ways. In an exemplary embodiment, the acknowledged alarm foran out-of-normal-range physiological parameter can include at least acolor change on the display screen 300 for the out-of-normal-rangephysiological parameter. The portion(s) of the screen 300 associatedwith the out-of-range parameter that changed to indicate the alarm canchange again similar to that discussed above regarding the change toindicate the alarm, e.g., change from one color to another color.Various embodiments of acknowledging alarms for physiological parametersare discussed in further detail in U.S. application Ser. No. 13/803,667entitled “Methods, Systems, And Devices For Monitoring And DisplayingMedical Parameters For A Patient” filed on Mar. 14, 2013.

FIG. 12 shows an embodiment of the display screen 300 afteracknowledgement of an alarm regarding out-of-normal-range CPP. Inresponse to the alarm being acknowledged, e.g., in response toactivation of an alarm silence button, an acknowledgement was triggered,thereby changing a background color for the CPP textual display 326 inthe current data window 312 from one color, e.g., red, to another color,e.g., white, in FIG. 12. An alarm symbol 327 can remain present on thedisplay screen 300 even after the alarm has been acknowledged, as shownin FIG. 12.

The trends window 310 can be configured to indicate whether or not aphysiological parameter was in an alarm state during the trend timeperiod shown in the trends window 310. In other words, the trends window310 can be configured to indicate when an alarm was triggered for aphysiological parameter, e.g., when the physiological parameter wasoutside its associated normal range, and how long the alarm persisted,e.g., when the physiological parameter returned to within its associatednormal range. The trends window 310 can thus be configured to providehistorical alarm data regarding each of the physiological parameters,thereby facilitating patient care and/or saving time by providing moreinformation regarding the patient in one place. In an exemplaryembodiment, the trends window 310 can be configured to indicate specificdates and times during the trend time period shown in the trends window310 in which any of the physiological parameters were outside theirrespective normal ranges.

The trends window 310 can be configured to indicate historical alarminformation for a physiological parameter in a variety of ways. In anexemplary embodiment, the trends window 310 can be configured to includean alarm marker within the graphical display of the physiologicalparameter which had one or more alarm states during the trend timeperiod shown in the trends window 310. If multiple alarm states existedfor the parameter, the parameter's graphical display can include analarm marker for each of the alarm states, thereby providing a morecomplete picture of the parameter's history.

The alarm marker can be positioned within the graphical display adjacentthe dates and times corresponding to the alarm state, e.g., adjacent thetrendline within the graphical display at the corresponding date andtime. Being positioned adjacent the dates and times corresponding to thealarm state can facilitate comparison of alarm states for differentphysiological parameters because the alignment/misalignment of the alarmmarkers can be easily visually compared as being at same or differentdates and times.

The alarm marker can have a variety of configurations, e.g., a highlycolor-contrasted portion of the trends window 310, a symbol shown on thetrends window 310, shading within the trends window 310, a boldedportion of the trendline, a line adjacent the trendline, etc. A color ofthe alarm marker can correspond to a color of the alarm provided on thedisplay screen, which in the illustrated embodiment is a red color, butany color(s) can be used. In the illustrated embodiment of FIG. 3, thealarm marker includes a line extending timewise within a graphicaldisplay and a shaded portion within the graphical display in a portionthereof corresponding to the line. By way of example, FIG. 3 shows alarmmarker shading 348 s and an alarm marker line 3481 at two differenttimes in the ICP graphical display 348, alarm marker shading 352 s andan alarm marker line 3521 at three different times in the MAP graphicaldisplay 352, and alarm marker shading 374 s and an alarm marker line3741 at two different times in the EVD graphical display 374. The alarmmarkers in the illustrated embodiment can allow dates and times ofalarms for different parameters to be easily compared, as mentionedabove, such as to determine that each of ICP and ICP2 (EVD) hadconcurrent alarm states at about 19:10:00, as shown in FIG. 3. No alarmmarker is shown in the CPP graphical display 378, thereby indicatingthat CPP was not in an alarm state in the trend time period shown on thetrends screen 310.

Similar to that discussed above regarding the alarm for the normalrange, to facilitate assessment of the patient's condition, a goal alarmcan be provided if any of the physiological parameters are outside theirassociated goal range. In an exemplary embodiment, the goal alarm can beprovided for a physiological parameter when the physiological parameteris outside its associated goal range, which can be nested within thenormal range, and is within its associated normal range. The goal alarmcan indicate to medical personnel, e.g., an attending nurse, a doctor,etc., that the patient may need assessment and/or treatment because thephysiological parameter associated with the goal alarm is not in anoptimal range and therefore may be heading outside its normal range. Inother words, the patient's condition may be deteriorating but can beassessed and/or the patient can be treated prior to the patient being ina more dire condition. The goal alarm can thus function in apreventative way. The goal alarm can be provided in a variety of ways.

In an exemplary embodiment, when an average of one of the physiologicalparameters, e.g., ICP, MAP/BP, HR, EVD level, CPP, PbO2, and Tb, iswithin its associated predetermined goal range, and hence is also withinits associated normal range, a goal indicator can be shown on thedisplay screen 300. In other words, when a current value of one of thephysiological parameters is within its associated goal range, e.g.,below its associated predetermined upper goal limit and above itsassociated predetermined lower goal limit, the goal indicator can betriggered to be displayed on the screen 300 for that physiologicalparameter. The device's processor can be configured to determine whetherthe physiological parameters' current values are within their respectivethe goal ranges and can be configured to cause the goal indicator to beshown on the screen 300. The statuses of the physiological parametersshown on the display screen 300 can thus be quickly assessed by checkingthe display screen 300, e.g., by a user looking at the display screen,to determine if a goal indicator is present on the screen 300 for eachof the physiological parameters. The goal alarm for a physiologicalparameter can, in an exemplary embodiment, include absence of the goalindicator from the screen 300 for that physiological parameter. Variousembodiments of providing goal alarms and goal indicators forphysiological parameters are discussed in further detail in U.S.application Ser. No. 13/803,667 entitled “Methods, Systems, And DevicesFor Monitoring And Displaying Medical Parameters For A Patient” filed onMar. 14, 2013.

The trends window 310 can be configured to indicate whether or not aphysiological parameter was within its goal range during the trend timeperiod shown in the trends window 310. In other words, the trends window310 can be configured to indicate when a goal alarm was triggered for aphysiological parameter, e.g., when the physiological parameter wasoutside its associated goal range, and how long the goal alarmpersisted, e.g., when the physiological parameter returned to within itsassociated goal range. The trends window 310 can thus be configured toprovide historical goal alarm data regarding each of the physiologicalparameters, thereby facilitating patient care and/or saving time byproviding more information regarding the patient in one place. In anexemplary embodiment, the trends window 310 can be configured toindicate specific dates and times during the trend time period shown inthe trends window 310 in which any of the physiological parameters werewithin their respective goal ranges.

The trends window 310 can be configured to indicate historical goalalarm information for a physiological parameter in a variety of ways. Inan exemplary embodiment, the trends window 310 can be configured toinclude a goal marker within the graphical display of the physiologicalparameter which was within its associated goal range during the trendtime period shown in the trends window 310. If the parameter was withinits associated goal range at different dates/times, the parameter'sgraphical display can include a goal marker for each of the dates/times,thereby providing a more complete picture of the parameter's history.

The goal marker can be positioned within the graphical display adjacentthe dates and times corresponding to the date/time the parameter waswithin its associated goal range, e.g., adjacent the trendline withinthe graphical display at the corresponding date and time. Beingpositioned adjacent the dates and times corresponding to the goal statecan facilitate comparison of goal states for different physiologicalparameters because the alignment/misalignment of the goal markers can beeasily visually compared as being at same or different dates and times.

The goal marker can have a variety of configurations similar to thatdiscussed above regarding the alarm marker and can include, e.g., ahighly color-contrasted portion of the trends window 310, a symbol shownon the trends window 310, shading within the trends window 310, a boldedportion of the trendline, a line adjacent the trendline, etc. A color ofthe goal marker can correspond to a color of the alarm provided on thedisplay screen, which in the illustrated embodiment is a bright greencolor, but any color(s) can be used. In the illustrated embodiment ofFIG. 3, the goal marker includes a line extending timewise within agraphical display. By way of example, FIG. 3 shows a goal marker line352 g at one time in the MAP graphical display 352, a goal alarm markerline 374 g at one time in the EVD graphical display 374, and a goalmarker line 378 g at one time in the CPP graphical display 378. The goalmarkers in the illustrated embodiment can allow dates and times ofalarms for different parameters to be easily compared, as mentionedabove, such as to determine that none of ICP, MAP, EVD, and CPP in anycombination had any overlapping time(s) of being within their associatedgoal ranges. No goal marker is shown in the ICP graphical display 348,thereby indicating that ICP was not within its associated goal range inthe trend time period shown on the trends screen 310.

The trends window can be configured to allow user selection of a dateand time within the currently-selected trend time period. The trend timeperiod spans over multiple times but may not span over more than onedate depending on a length of the trend time period, a start date andtime for the trend time period, and an end date and time for the trendtime period. Data corresponding to the user-selected date and time canbe displayed on the trends window 310, thereby facilitating analysis ofthe patient's condition at a specific point in time. Different points intime can be compared against one another, which can facilitatediagnosis, assessment, and/or treatment of the patient and/or canfacilitate detection of patterns using data from a plurality ofpatients.

The date and time within the currently-selected trend time period can beselected in a variety of ways. In one embodiment, the trends window 310can include a text entry field (not shown) configured to allow userinput of a date and time to allow selection thereof. In anotherembodiment, the trends window 310 can include a calendar featureconfigured to allow a user to scroll through dates and times to select aspecific date and time. In yet another embodiment, the trends window 310can include a trend preferences button (not shown) configured to beactivated to allow adjustment of a selected time within the trend timeperiod, such as by providing a preferences window in which start and enddates and times of the trend time period can be selected. As in theillustrated embodiment, the trends window 310 can have a movable timemarker displayed thereon that can be configured to be movable on thedisplay screen 300 so as to select a date and time within the trend timeperiod.

The time marker can have a variety of configurations. In the illustratedembodiment, the time marker includes a scroll bar 309 configured to bemovable along the timeline 307. The timeline 307 is positioned below allof the graphical displays 348, 352, 374, 378 shown in the trends window310, but the timeline 307 can be in other positions, e.g., above thegraphical displays, between adjacent graphical displays, etc. The scrollbar 309 is in the form of a slidable solid line in the illustratedembodiment but can have other forms, e.g., a slidable dotted line, anarrow and/or other symbol adjacent the graphical displays, etc. Startand end dates and times of the timeline 307 can be defined by start andend dates and times of the trend time period. In the illustratedembodiment, the timeline 307 starts at 12:05:00 on 20/09/20 and spanseight hours (the selected trend time period) to 20:05:00 on 20/09/20. Aposition of the scroll bar 309 along the timeline 307 can define theselected date and time. In the illustrated embodiment, the selected dateis 20/09/20 and the selected time is 14:21:10.

In an exemplary embodiment, the scroll bar 309 can be configured to bemovable along each of the trendlines 348 t, 352 t, 374 t, 376 tcurrently shown in the graphical displays 348, 352, 374, 378 of thetrends window 310. The scroll bar 309 can be configured to movesimultaneously along each of the displayed trendlines 348 t, 352 t, 374t, 376 t. The slidable line 309 can thus indicate a selected positionalong each of the displayed trendlines 348 t, 352 t, 374 t, 376 t at theselected date and time. The scroll bar 309 can thus be configured toselect a same specific date and time for each of at least the displayedphysiological parameters such that data for each of at least thedisplayed physiological parameters at the selected date and time can beprovided on the display screen 300. The display screen 300 can thus beconfigured to provide a snapshot of the patient's condition at theselected date and time.

The scroll bar 309 can be movable along the timeline 307 in a variety ofways. For example, the scroll bar 309 can be configured to be selected,e.g., by touch on the touchscreen, and moved on the screen 300 by usertouch gesture. For another example, the scroll bar 309 can be configuredto be selected, e.g., by touch on the touchscreen, at a controllerportion 309 c thereof. The controller portion 309 c can be positionedalong the timeline 307 and slidable therealong in a drag and dropfashion so as to move the scroll bar 309 through the timeline 307 andacross the displayed trendlines 348 t, 352 t, 374 t, 376 t. The scrollbar 309 can be movable in other ways, such as by being selectable alongany portion thereof via touchscreen or pointer device and dragged anddropped along the timeline 307, by entering a date and time into a textentry box and thereby causing the scroll bar 309 to move to that dateand time along the timeline 307, etc.

Various types of data can be provided regarding each of thephysiological parameters at the selected date and time, e.g., at thedate and time indicated by the position of the scroll bar 309. In anexemplary embodiment, the trends window 310 can include any one or moreof a detail trends window, an assessment window, and a notificationwindow to be displayed at the selected date and time. Each of the detailtrends window, the assessment window, and the notification window arediscussed in further detail below.

The detail trends window can be configured to show information for oneor more physiological parameters in a detail time period surrounding theselected date and time. In an exemplary embodiment, the detail timeperiod can less than the trend time period, e.g., one minute, fiveminutes, a single heartbeat, three heartbeats, ten minutes, etc.,although virtually any time period can be used as the detail timeperiod. The detail time period can thus show a more detailed portion ofa trendline during a time period that includes the selected date andtime. Similar to that discussed above regarding the current time period,the detail time period can be a predetermined amount of time that can bea default, preprogrammed time period, e.g., preprogrammed into aprocessor, or can be customized for a particular patient. The detailtime period can be adjustable, also similar to that discussed above withrespect to the current time period. The detail time period can becustomized and/or adjusted in a variety of ways, e.g., by activating amain menu button (not shown) to cause a preferences window to beprovided in which the detail time period can be customized and/oradjusted.

The detail trends window can be configured to be shown on the displayscreen 300 in a variety of ways. In an exemplary embodiment, allavailable detail trends windows for physiological parameters havinggraphical displays on the trends window 310 can be displayed for thedate and time defined by the scroll bar's position within the trend timeperiod upon activation of the detail time period button 336, e.g., bytouching the button 336 on the touchscreen. Additionally oralternatively, the detail trends window for a selected one of thephysiological parameters can be shown on the display screen 300 byselecting the trendline for the selected one of the physiologicalparameters at a location of the scroll bar 309 along that parameter'strendline. Each of the displayed trendlines 348 t, 352 t, 374 t, 376 tcan include a details icon 348 i, 352 i, 374 i, 376 i thereon at thelocation of the scroll bar 309 therealong. The details icons 348 i, 352i, 374 i, 376 i in the illustrated embodiment each include a circle onthe scroll bar 309, but the details icons 348 i, 352 i, 374 i, 376 i canhave any of a variety of configurations, e.g., an “x” and/or othersymbol on the scroll bar 309, a “details” button on the screen 300adjacent each of the graphical displays that can be configured to beselected to show the detail trends window for its associated trendline,a master “details” button on the screen 300 configured to be selected toshow the detail trends for each of the displayed trendlines, etc.

FIG. 13 shows an embodiment of the trends window 310 including at leastone detail trends window. In the illustrated embodiment, the ICP detailsicon 348 i has been selected on FIG. 3 to cause an ICP detail trendswindow 348 w to be displayed on the trends window 310, and the EVDdetails icon 374 i has been selected on FIG. 3 to cause an EVD detailtrends window 374 w to be displayed on the trends window 310. The detailtrends windows 348 w, 374 w in the illustrated embodiment each include azoomed-in view of their respective trendlines 348 t, 374 w for thedetail trend time period centered at the selected date and time, but thedetail trends windows can have a variety of configurations. The detailtrends windows 348 w, 374 w are displayed on the trends window 310 inthe illustrated embodiment, but detail trends window can be configuredto be displayed in another window, e.g., a dedicated detail trendswindow. The detail trends windows 348 w, 374 w can be configured toremain displayed on the screen 300 until deselected, e.g., theirassociated details icons 348 i, 374 i are again activated, the detailtrends windows 348 w, 374 w are dragged and dropped off the screen 300,etc. The detail trends windows 348 w, 374 w can be configured toautomatically update if the scroll bar 309 is moved while the detailtrends windows 348 w, 374 w are shown on the screen 300. Alternatively,the detail trends windows 348 w, 374 w can be configured to disappearfrom the screen 300 if the scroll bar 309 is slid along the trendlines348 t, 352 t, 374 t, 376 t while the detail trends windows 348 w, 374 ware shown on the screen 300.

When all available detail trends windows are shown, e.g., on the trendswindow 310 or elsewhere, the detail time period button 336 can beconfigured to be deactivated, e.g., removed from the display screen 300,grayed out (as in the illustrated embodiment), struck out (as in theillustrated embodiment, in which the button 336 is crossed out with an“X”), etc., thereby indicating that no more detail trends windows areavailable for viewing.

FIG. 14 shows an embodiment of the trends window 310 of FIG. 10 afterthe ICP and EVD details icons 348 i, 374 i have been activated so as tocause their associated detail trends windows 348 w, 374 w to be shown onthe screen 300. FIG. 15 shows an embodiment of the trends window 310 ofFIG. 11 after the ICP and EVD details icons 348 i, 374 i have beenactivated so as to cause their associated detail trends windows 348 w,374 w to be shown on the screen 300. FIG. 16 shows an embodiment of thetrends window 310 of FIG. 6 after the ICP detail icons 348 i has beenactivated so as to cause its associated detail trends window 348 w to beshown on the screen 300.

The assessment window can be configured to show assessment informationregarding one or more diagnostic parameters for the patient at and/orsurrounding the selected date and time. Examples of diagnosticparameters include pupil reading, Glasgow Coma Scale (GCS), EVD level,Acute Physiology and Chronic Health Evaluation (APACHE), SimplifiedAcute Physiology Score (SAPS), Paediatric Index of Mortality (PIM2),Sequential Organ Failure Assessment (SOFA) score, Cancer Mortality Model(CMM), Mortality Prediction Model (MPM), Risk, Injury, Failure, Loss andEnd-stage (RIFLE) kidney classification, Child-Pugh (CP), Ranson score,Multiple Organ Dysfunction Score (MODS), and Logistic Organ DysfunctionSystem (LODS). In a neurological context, exemplary diagnosticparameters include pupil reading, GCS, and EVD level.

The display screen 300 can be configured to show an assessment graphicaldisplay 351 that corresponds to the trend time period and that includesassessment information in graphical form for the one or more diagnosticparameters. The assessment graphical display 351 is shown positionedbelow all of the visible physiological parameter graphical displays 348,352, 374, 378 on the trends window 310 in the illustrated embodiment ofFIG. 3, but the assessment graphical display 351 can be positioned aboveall of the visible physiological parameter graphical displays 348, 352,374, 378 or positioned between two of the visible physiologicalparameter graphical displays 348, 352, 374, 378.

The assessment graphical display 351 can be configured to showdiagnostic parameter assessment information in graphical or pictorialform. The diagnostic parameters in the illustrated embodiment includepupil reading, GCS, and EVD level, but as mentioned above, any one ormore diagnostic parameters can be tracked for a patient. In an exemplaryembodiment, each of the available diagnostic parameters can include agraph line 335 g, 339 g, 341 g for each of the pupil reading, GCS, andEVD level diagnostic parameters that extends through the trend timeperiod. The scroll bar 309 can be configured to be movable along each ofthe graph line 335 g, 339 g, 341 g, similar to that discussed aboveregarding the trendlines 348 t, 352 t, 374 t, 376 t currently shown inthe graphical displays 348, 352, 374, 378 of the trends window 310. Thescroll bar 309 can thus be configured to move simultaneously along eachof the graph lines 335 g, 339 g, 341 g and the displayed trendlines 348t, 352 t, 374 t, 376 t. The slidable line 309 can thus indicate aselected position along each of the displayed graph lines 335 g, 339 g,341 g and the displayed trendlines 348 t, 352 t, 374 t, 376 t at theselected date and time.

Each of the graph lines 335 g, 339 g, 341 g can include assessmentmarkers therealong. Each of the assessment markers can indicate a pointwithin the trend time period, e.g., a specific date and time within thetrend time period shown on the trends window 310, that corresponds to atime that the patient was assessed with respect to the assessmentmarker's associated diagnostic parameter. In other words, each of theassessment markers can indicate a point within the trend time period atwhich assessment information was received by the system for itsassociated diagnostic parameter. In the illustrated embodiment, thepupil reading graph line 335 g has four assessment markers therealong,the GCS graph line 339 g has four assessment markers therealong, and theEVD level graph line 341 g has three assessment markers therealong.

The assessment markers can have a variety of configurations. Examples ofthe assessment markers include icons, geometric shapes, symbols,numbers, letters, alphanumeric characters, etc. In an exemplaryembodiment, each of the diagnostic parameters can have its own uniqueassessment marker. Unique assessment markers can facilitate quick visualdistinction between different assessment markers that can besimultaneously shown on the trends screen 310. In the illustratedembodiment of FIG. 3, the unique assessment markers for pupil readinginclude icons with an eye graphic, the assessment markers for GCSinclude icons with a line graph graphic, and the assessment markers forEVD level include icons with a fluid drop graphic. In the trend timeperiod shown in FIG. 3, the pupil reading graph line 335 g has three eyegraphic icon assessment markers therealong, the GCS graph line 339 g hasthree line graph icon assessment markers therealong, and the EVD levelgraph line 341 g has three fluid drop icon assessment markerstherealong.

One or more assessment markers can be provided that are common to all ofthe diagnostic parameters. In an exemplary embodiment, each of thediagnostic parameters can share a common assessment marker configured toindicate a change in a diagnostic parameter. The common assessmentmarker can have a different color than the unique assessment markers,which can facilitate visual detection of the change. Alternatively, eachof the diagnostic markers can include a unique assessment markerconfigured to indicate a change in the diagnostic marker. In theillustrated embodiment, each of the diagnostic parameters can share acommon assessment marker in the form of a parallelogram shape having abright yellow color, although as mentioned above, other shapes andcolors can be used. In the trend time period shown in FIG. 3, the pupilreading graph line 335 g has one change assessment markers therealong,the GCS graph line 339 g has one change assessment markers therealong,and the EVD level graph line 341 g has zero change assessment markerstherealong.

FIGS. 5, 6, and 16 illustrate embodiments in which at least onediagnostic parameter does not include any assessment markers in thepresently selected trend time period, which is the EVD graph line 341 gin these embodiments. One or more diagnostic parameters may not haveavailable information for a variety of reasons, such as no diagnosticinformation being gathered at all or gathered during the selected timeperiod.

The diagnostic parameter assessment information, pupil readinginformation, GCS information, EVD level information, etc., can bereceived by the system in a variety of ways. In an exemplary embodiment,the display screen 300 can be configured to provide user access to adiagnostic parameter entry screen (not shown) configured to allow a userto manually enter diagnostic parameter assessment information andassociate a date and time therewith, e.g., a date and time that theinformation was gathered by medical personnel. The diagnostic parameterentry screen can have a variety of configurations, as will beappreciated by a person skilled in the art, such as by providing a textentry box, a drop-down menu of diagnostic parameter options, etc.Various embodiments of entering information into a system via a userinterface are described in further detail in U.S. Pat. Pub. No.2009/0005703 entitled “Medical Monitor User Interface” filed Jun. 27,2007.

The assessment markers can be configured to be automatically provided inthe assessment graphical display 351 for the diagnostic parameters alongtheir associated graph lines 335 g, 339 g, 341 g. In other words, if thesystem has one or more diagnostic parameter assessment information,e.g., stored in a memory thereof, that falls within the currentlyselected trend time period, assessment marker(s) for that diagnosticparameter assessment information can be automatically provided on theappropriate ones of the graph lines 335 g, 339 g, 341 g.

The display screen 300 can be configured to show the assessmentgraphical display 351 simultaneously with an assessment window 333. Theassessment window 333 can be configured to provide the data associatedwith the assessment markers in the assessment graphical display 351. Inother words, the assessment window 333 can provide the numerical, text,and/or other clinically relevant data associated with the diagnosticparameters.

The assessment window 333 can be configured to be shown on the displayscreen 300 in a variety of ways. In an exemplary embodiment, assessmentinformation for each available diagnostic parameter can be displayed inthe assessment window 333 for the date and time defined by the scrollbar's position within the trend time period and along each of thediagnostic parameter's graph lines 335 g, 339 g, 341 g. The diagnosticparameter(s) can have information available at the selected date andtime, but in some instances, diagnostic information may not have beenreceived by the system at exactly the selected date and time. Theassessment window 333 can thus be configured to show information at theselected date and time and/or at dates/times adjacent to the selecteddate and time, e.g., before and/or after the selected date and time. Theassessment window 333 can be configured to show assessment informationfor a diagnostic parameter at a nearest date and time before theselected date and time at which information was received for thediagnostic parameter and/or to show assessment information for adiagnostic parameter at a nearest date and time after the selected dateand time at which information was received for the diagnostic parameter.

In an exemplary embodiment, the assessment window 333 can be configuredto concurrently show assessment information for each diagnosticparameter being tracked, gathered, etc. for the patient. In this way,the assessment window 333 can provide a complete picture of thepatient's diagnostic assessment. If more diagnostic parameters areavailable than can be shown at a single time, the assessment window 333can include a scroll element, similar to that discussed above. If aplurality of diagnostic parameters are available, an order in which thediagnostic parameters are displayed within the assessment window 333 canbe adjusted, similar to that discussed above regarding adjustment of theorder of graphical displays within the trends window 310. In anotherembodiment, the assessment window 333 can be configured to show onlyassessment information for one diagnostic parameter at a time, with eachdiagnostic parameter being selectable for display, e.g., by activationof an assessment button (not shown).

The assessment window 333 can be configured to be displayed concurrentlywith the trends window 310. The display screen 300 can thus provide afuller snapshot of the patient's condition. The assessment window 333can, however, be configured to be displayed separately from the trendswindow 310, e.g., in its own dedicated window.

The assessment window 333 can be configured to be displayedautomatically with the trends window 310, e.g., when the trends tab 306is selected by a user, whether or not any assessment information isavailable at and/or adjacent to the selected date and time.Alternatively, the assessment window 333 can be configured to bedisplayed in response to a user input request for assessmentinformation, e.g., by activating an assessment button (not shown) on thedisplay screen 300, by selecting an assessment tab 343 on the trendswindow 310, etc.

In the illustrated embodiment of FIG. 3, the assessment window 333includes pupil reading assessment information 335, GCS assessmentinformation 339, and EVD level assessment information 341. However, asmentioned above, any one or more diagnostic parameters can be shown inan assessment window. None of the diagnostic parameters have assessmentinformation associated therewith at the selected date and time withinthe trend time window in the illustrated embodiment. The assessmentwindow 333 thus shows assessment information for each diagnosticparameter at a nearest date and time before the selected date and timeat which information was received for the diagnostic parameter and showsassessment information for a diagnostic parameter at a nearest date andtime after the selected date and time at which information was receivedfor the diagnostic parameter.

The assessment window 333 in the illustrated embodiment is displayedconcurrently with the trends window 310, but as mentioned above, theassessment window 333 can be otherwise displayed. The assessment tab 343is selected in the embodiment shown in FIG. 3 such that the assessmentwindow 333 is shown. One or more other parameter information windows canbe selected and shown, e.g., a notification window that can be selectedvia a notification tab 349.

The notification window can be configured to show notificationinformation regarding one or more medically-related events that occurredas related to the patient at and/or surrounding the selected date andtime. By being configured to provide notification of medically-relatedevents, the display screen 300 can allow a user viewing the screen 300to more easily determine why one or more physiological parameters and/ordiagnostic parameters may have changed at a certain point or during acertain period of time. In other words, the occurrence of amedically-related event can help inform why a particular parameterchanged at a certain time. In general, medically-related events includeevents that can affect one or more physiological parameters. Generalexamples of medically-related events include interventions (e.g.,actions performed by medical personnel as related to the patient such asmedication administration, adjustment of EVD, administration of oxygen,etc.), planned or unplanned events (e.g., spontaneously occurring orpurposefully occurring events that happened to the patient, such as aseizure, an MRI image being taken, providing a meal, etc.), and notes(e.g., information noted by medical personnel as potentially havingimportance in the patient's treatment and care such as movement of thepatient to another area of the hospital). Examples of medically-relatedevents include the administration of a medication by a caregiver, theadjustment of a sensing device that monitors ICP and/or otherphysiological parameter, taking the patient's temperature, caregiverobservations, moving the patient to another room, transporting thepatient, reactivity, cleaning the patient, taking an MRI or other scanof the patient, the patient eating, the patient having a family/friendvisitor, oxygen challenge, the patient being awake or asleep, etc. Forexample, notification information indicating that a patient received adrug at a particular time can facilitate a medical practitioner'sassessment as to whether the drug had the desired clinical effect basedon trends of one or more physiological parameters following theparticular time. For another example, in a neurological context, anymovement of the patient can affect ICP such that notificationinformation providing notice that a patient was taken for an MRI at acertain time could help explain a change in ICP measurement values atand/or after the certain time.

The display screen 300 can be configured to show the notificationgraphical display 353 that corresponds to the trend time period and thatincludes notification information in graphical form for the one or morediagnostic parameters. FIG. 17 illustrates an embodiment of thenotification graphical display 353 when the notification tab 349 hasbeen selected. The notification graphical display 353 is shownpositioned below all of the visible physiological parameter graphicaldisplays 348, 352, 374, 378 and above the assessment graphical display351 on the trends window 310 in the illustrated embodiment of FIG. 17,but the notification graphical display 353 can be positioned above orbelow any one or more of the visible physiological parameter graphicaldisplays 348, 352, 374, 378 and the assessment graphical display 351.

The notification graphical display 353 can be configured to shownotification information in graphical or pictorial form. Thenotification information in the illustrated embodiment includesinterventions, unplanned events, and notes, but as mentioned above, anynotification information can be provided. Each of the interventions,unplanned events, and notes can include a plurality of different typesof notifications that fall under its associated general category ofinterventions, unplanned events, and notes. In an exemplary embodiment,each of the available medically-related events can include a graph line359 g, 361 g, 363 g for each of the interventions, unplanned events, andnotes medically-related events that extend through the trend timeperiod. The scroll bar 309 can be configured to be movable along each ofthe graph line 359 g, 361 g, 363 g, similar to that discussed aboveregarding the graph lines 335 g, 339 g, 341 g and the trendlines 348 t,352 t, 374 t, 376 t. The scroll bar 309 can thus be configured to movesimultaneously along each of the graph lines 359 g, 361 g, 363 g and thedisplayed trendlines 348 t, 352 t, 374 t, 376 t. The slidable line 309can thus indicate a selected position along each of the displayed graphlines 359 g, 361 g, 363 g and the displayed trendlines 348 t, 352 t, 374t, 376 t at the selected date and time.

Each of the graph lines 359 g, 361 g, 363 g can include notificationmarkers therealong. The notification markers can generally be configuredsimilar to the assessment markers discussed above. Each of thenotification markers can indicate a point within the trend time period,e.g., a specific date and time within the trend time period shown on thetrends window 310, that corresponds to a time that a medically-relatedevent occurred with respect to the patient. In other words, each of thenotification markers can indicate a point within the trend time periodat which notification information was received by the system for itsassociated medically-related event. In the illustrated embodiment ofFIG. 17, the intervention graph line 359 g has five notification markerstherealong, the events graph line 361 g has thirteen notificationmarkers therealong, and the notes graph line 363 g has four notificationmarkers therealong.

The notification markers can have a variety of configurations. Examplesof the notification markers include icons, geometric shapes, symbols,numbers, letters, alphanumeric characters, etc. In an exemplaryembodiment, each of the medically-related events can have its own uniquenotification marker. However, one or more notification markers can beprovided that are common to all of the medically-related events. Uniquenotification markers can facilitate quick visual distinction betweendifferent notification markers that can be simultaneously shown on thetrends screen 310. In the illustrated embodiment of FIG. 3, the uniquenotification markers for interventions include icons labeled “I,” thenotification markers for events include icons labeled “E,” and thenotification markers for notes include word bubble symbols. One or moreof the graph lines 359 g, 361 g, 363 g can lack any notification markersfor a given trend time period, e.g., because no medically-related eventsoccurred during that time period.

The notification information can be received by the system in a varietyof ways. In an exemplary embodiment, the display screen 300 can beconfigured to provide user access to a notification information entryscreen (not shown) configured to allow a user to manually enternotification information and associate a date and time therewith, e.g.,a date and time that the information was gathered by medical personnel.The notification information entry screen can have a variety ofconfigurations, as will be appreciated by a person skilled in the art,such as by providing a text entry box, a drop-down menu of diagnosticparameter options, etc. As mentioned above, various embodiments ofentering information into a system via a user interface are described infurther detail in U.S. Pat. Pub. No. 2009/0005703 entitled “MedicalMonitor User Interface” filed Jun. 27, 2007. The notificationinformation can be configured to be automatically provided, such as forunplanned or planned events sensed by a sensing device, e.g., opening orclosing of an EVD, when EVD pressure is measured and an ICP sensingdevice is exposed, triggering of an alarm or a goal alarm, etc.

The notification markers can be configured to be automatically providedin the notification graphical display 353 for the medically-relatedevents along their associated graph lines 359 g, 361 g, 363 g. In otherwords, if the system has one or more notification information, e.g.,stored in a memory thereof, that falls within the currently selectedtrend time period, notification marker(s) for that notificationinformation can be automatically provided on the appropriate ones of thegraph lines 359 g, 361 g, 363 g.

The display screen 300 can be configured to show the notificationgraphical display 353 simultaneously with a notification window 345. Thenotification window 345 can be configured to provide the data associatedwith the assessment markers in the notification graphical display 353.In other words, the notification window 345 can provide the numerical,text, and/or other clinically relevant data associated with themedically-related events.

The notification window 345 can be configured to be shown on the displayscreen 300 in a variety of ways. In an exemplary embodiment,notification information for each available medically-related event canbe displayed in the notification window 345 for the date and timedefined by the scroll bar's position within the trend time period andalong each of the graph lines 359 g, 361 g, 363 g. The medically-relatedevent(s) can have information available at the selected date and time,but in some instances, notification information may not have beenreceived by the system at exactly the selected date and time. Thenotification window 345 can thus be configured to show information atthe selected date and time and/or at dates/times adjacent to theselected date and time, e.g., before and/or after the selected date andtime. The notification window 345 can be configured to show notificationinformation for a medically-related event at a nearest date and timebefore the selected date and time at which information was received forthe medically-related event and/or to show notification information fora medically-related event at a nearest date and time after the selecteddate and time at which information was received for themedically-related event.

In an exemplary embodiment, the notification window 345 can beconfigured to concurrently show notification information for eachmedically-related event regarding the patient. In this way, thenotification window 345 can provide a complete picture of the patient'streatment and care. If more medically-related events are available thancan be shown at a single time, the notification window 345 can include ascroll element, similar to that discussed above. If a plurality ofmedically-related events are available, an order that themedically-related events are displayed within the notification window345 can be adjusted, similar to that discussed above regardingadjustment of the order of graphical displays within the trends window310. In another embodiment, the notification window 345 can beconfigured to show only notification information for onemedically-related event at a time, with each medically-related eventbeing selectable for display, e.g., by activation of a notificationbutton (not shown).

The notification window 345 can be configured to be displayedconcurrently with the trends window 310. The display screen 300 can thusprovide a fuller snapshot of the patient's condition. The notificationwindow 345 can, however, be configured to be displayed separately fromthe trends window 310, e.g., in its own dedicated window.

The notification window 345 can be configured to be displayedautomatically with the trends window 310, e.g., when the trends tab 306is selected by a user, whether or not any notification information isavailable at and/or adjacent to the selected date and time.Alternatively, the notification window 345 can be configured to bedisplayed in response to a user input request for notificationinformation, e.g., by activating a notification button (not shown) onthe display screen 300, by selecting the notification tab 349 on thetrends window 310, etc.

In the illustrated embodiment of FIG. 3, the notification window 345includes interventions information 359, events information 361, andnotes information 363. However, as mentioned above, any one or moremedically-related events can be shown in a notification window. None ofthe medically-related events have notification information associatedtherewith at the selected date and time within the trend time window inthe illustrated embodiment. The notification window 345 thus showsnotification information for each medically-related event at a nearestdate and time before the selected date and time at which information wasreceived for the medically-related event and shows notificationinformation for a medically-related event at a nearest date and timeafter the selected date and time at which information was received forthe medically-related event.

The notification window 345 in the illustrated embodiment is displayedconcurrently with the trends window 310, but as mentioned above, thenotification window 345 can be otherwise displayed. The assessment tab349 is selected in the embodiment shown in FIG. 17 such that thenotification window 345 is shown.

When the notification tab 349 is selected, the assessment window 333 andthe assessment graphical display 351 can be configured to be removedfrom the display screen 300 or minimized on the display screen 300.Similarly, when the assessment tab 343 is selected, a notificationwindow 357 and the notification graphical display 353 can be configuredto be removed from the display screen 300 or minimized on the displayscreen 300. In the illustrated embodiment of FIG. 3, the notificationgraphical display 353 is minimized on the display screen 300 when theassessment tab 343 is selected. The minimized notification graphicaldisplay 353 can still include notification markers thereon, as shown inthe illustrated embodiment. A user viewing the display screen 300 canthus receive at least some notification information despite thenotification tab 349 not being selected. The user can thus better decidewhether to access the notification information. In the illustratedembodiment of FIG. 17, the assessment graphical display 351 is minimizedon the display screen 300 when the notification tab 349 is selected. Theminimized assessment graphical display 351 can still include assessmentmarkers thereon, as shown in the illustrated embodiment. A user viewingthe display screen 300 can thus receive at least some assessmentinformation despite the assessment tab 343 not being selected. The usercan thus better decide whether to access the assessment information.

FIG. 18 shows an embodiment of the trend window 310 of FIG. 3 when thedevice is undocked, e.g., is running from an on-board power supply suchas a battery. The undocked state of the device can be indicated in anyone or more ways, such as by changing a background color of the displayscreen 300 (e.g., from black in FIG. 3 to yellow in FIG. 18, changingthe docking indicator 372 (e.g., from a docked icon in FIG. 3 to anundocked icon in FIG. 18), a textual identifier (not shown) (e.g.,“UNDOCKED”, etc.), etc. Providing clear notice of the device beingundocked can help prevent the device from running out of power, goingout of range, etc.

As mentioned above, selection of the monitor tab 302 on the displayscreen 300 can cause a monitor window (not shown) to be shown on thescreen 300. The monitor window can be configured to show information forone or more physiological parameters in the current time period. Themonitor window can be configured to show information for one or morephysiological parameters in the current time period, e.g., the timeperiod for the current data window 312 of the trends screen 310. Ingeneral, the monitor window can show information similar to theinformation provided in the current data window 312. In an exemplaryembodiment, the monitor window can provide more information than theinformation available in the current data window 312.

For each of the physiological parameters, the monitor window can beconfigured to show a textual display of parameter information for thecurrent time period and/or a graphical display of parameter informationfor the current time period. The graphical display can represent aparameter graphically with a graph line plotted over the current timeperiod. However, virtually any graphical representation can be used,such as a graph line, a bar graph, a plot of discrete data points,and/or other pictorial display. The textual display can represent aparameter textually and/or pictorially. In an exemplary embodiment, thetextual display can include information related to an average of theparameter values gathered and/or calculated during the current timeperiod including a current average (e.g., the current averageintracranial pressure), a current actual value (e.g., a most recentlymeasured and/or calculated ICP value), a normal range for the currentaverage, and a goal range for the current average. The textual displaycan, however, display one or more current values in addition to orinstead of the current average. Various embodiments of monitor windowsare described in further detail in U.S. Pat. Pub. No. 2009/0005703entitled “Medical Monitor User Interface” filed Jun. 27, 2007.

As mentioned above, selection of the hybrid tab 304 on the displayscreen 300 can cause a hybrid window (not shown) to be shown on thescreen 300. The hybrid window can be configured to show information forone or more physiological parameters over a current time period and canshow information for the one or more physiological parameters over thetrend time period. The hybrid window can thus facilitate comparison ofcurrent information with previously gathered information, which canfacilitate a more long term analysis of the patient's physiologicalparameters. The information for the one or more physiological parametersover the current time period can include information similar to thatdiscussed above regarding the information that can be shown on themonitor window. The information for the one or more physiologicalparameters over the other time period can include information similar tothat discussed above regarding the information that can be shown on thetrends window. The hybrid window can thus be configured as a hybrid ofthe monitor window and the trends window. The information displayed inthe hybrid window for each of the physiological parameters can be basedon data received by the monitoring device in any of a variety of ways,as discussed above. For each of the physiological parameters shown onthe screen, the hybrid window can be configured to show at least one ofa textual display of parameter information for the current time periodand a graphical display of parameter information for the current timeperiod, and at least one of a textual display of parameter informationfor a trend time period and a graphical display of parameter informationfor the trend time period. Embodiments of hybrid windows are describedin further detail in U.S. Pat. Pub. No. 2009/0005703 entitled “MedicalMonitor User Interface” filed Jun. 27, 2007.

As mentioned above, selection of the future tab 308 on the displayscreen 300 can cause a future window (not shown) to be displayed on thescreen 300. The future window can show information for one or morephysiological parameters in a future time period that is after thecurrent time period. The future time period can be a predeterminedamount of time that can be a default, preprogrammed time period, e.g.,preprogrammed into a processor, or can be customized for a particularpatient. The future time period can be, e.g., in a range of about fiveto sixty seconds, in a range of about five to ten seconds, a singleheartbeat, a few heartbeats of the patient, etc. The future time periodcan be adjustable similar to that discussed above, such as when a useractivates a preferences menu or soft button. Adjustment of the futuretime period can allow for various clinical protocols, as such protocolscan require tracking of a parameter over different time periods.

Any one or more physiological parameters can be shown on the futurewindow. The information displayed for each of the physiologicalparameters can be based on data received by the monitoring device in anyof a variety of ways, as discussed above. For each of the physiologicalparameters, the future window can be configured to show a textualdisplay of parameter information for the future time period and/or agraphical display of parameter information for the future time period,similar to the textual and graphical displays discussed above. Which oneor more of the physiological parameters have a textual display only,have a graphical display only, or have both a textual display and agraphical display can be user-adjusted, such as by dragging and droppingdisplays on the touchscreen or activating a preferences menu or softbutton. The future data can be shown in the future window in any one ormore ways, such as by scatter plots, spider plots, plotting oneparameter against another, plotting one parameter against another withina specific period of time, 3D plot (where the third axis is time).

The parameter information shown on the future window can be based onanalysis of actual parameters values gathered from the patient. In otherwords, the information for a physiological parameter in the future timeperiod can include projections of future parameter values based onactual values of that parameter gathered from the patient. Futureparameter values for a physiological parameter can be extrapolated fromthe actual values gathered from the patient for that parameter using anyone or more extrapolation techniques, as will be appreciated by a personskilled in the art. Examples of extrapolation techniques include linearextrapolation, linear extrapolation, conic extrapolation, and polynomialextrapolation. Various software known in the art can be used to performsuch extrapolation, such as Fityk (available under GNU General PublicLicense), Ch (marketed by SoftIntegration, Inc. of Davis, Calif.),ZunZun.com (online curve fitting), and savetman.com (online curvefitting using least squares fit with weights). The future data can becorrelated (e.g., autocorrelated and/or cross correlated) and/or thefuture data can be manipulated for frequency analysis.

FIGS. 3-18 are directed to user interfaces in a neurological context,e.g., for use in monitoring a patient with a traumatic brain injury.However, the methods, systems, and devices described herein areapplicable in other medical contexts and can be used in monitoring apatient having virtually any ailment(s). Also, while FIGS. 3-18 use ICP,MAP/BP, HR, EVD ICP, CPP, PbO2, and Tb, as exemplary physiologicalparameters, this is by way of illustration only. The methods, systems,and devices described herein can be applied to virtually anyphysiological parameters of a patient.

Any of the methods described herein can be performed by executing aprogram. The program can be stored on a computer readable medium, suchas compact disc, a diskette, a memory device, etc.

A person skilled in the art will appreciate that the present inventionhas application in conventional minimally-invasive and open surgicalinstrumentation as well application in robotic-assisted surgery.

The devices disclosed herein can also be designed to be disposed ofafter a single use, or they can be designed to be used multiple times.In either case, however, the device can be reconditioned for reuse afterat least one use. Reconditioning can include any combination of thesteps of disassembly of the device, followed by cleaning or replacementof particular pieces and subsequent reassembly. In particular, thedevice can be disassembled, and any number of the particular pieces orparts of the device can be selectively replaced or removed in anycombination. Upon cleaning and/or replacement of particular parts, thedevice can be reassembled for subsequent use either at a reconditioningfacility, or by a surgical team immediately prior to a surgicalprocedure. Those skilled in the art will appreciate that reconditioningof a device can utilize a variety of techniques for disassembly,cleaning/replacement, and reassembly. Use of such techniques, and theresulting reconditioned device, are all within the scope of the presentapplication.

One skilled in the art will appreciate further features and advantagesof the invention based on the above-described embodiments. Accordingly,the invention is not to be limited by what has been particularly shownand described, except as indicated by the appended claims. Allpublications and references cited herein are expressly incorporatedherein by reference in their entirety.

What is claimed is:
 1. A system, comprising: a display screen; and aprocessor configured to: receive a plurality of values for each of aplurality of physiological parameters measured from a patient over aperiod of time, cause a plurality of windows to be displayed on thedisplay screen, the plurality of windows comprising: a current valuewindow that shows a current value for each of the plurality ofphysiological parameters, and a trends window that shows a trendline foreach of the plurality of physiological parameters, each of thetrendlines indicating for its associated physiological parameter thevalues of the physiological parameter over the period of time, receivean input representing a user-selected time, cause a time marker to bedisplayed on the trends window, a position of the time marker relativeto each of the trendlines indicating the user-selected time within theperiod of time, the marker being movable simultaneously along each ofthe trendlines based on the user-selected time, cause an assessmentwindow to be displayed on the display screen that indicates a value ofeach of the plurality of physiological parameters at the selected time,receive a notification identifying a medically-related event experiencedby the patient at a time within the period of time, themedically-related event being an event that affects at least one of theplurality of physiological parameters, and cause at least onenotification marker to be displayed on at least one of the trendlines inresponse to the receipt of the notification, the notification markerbeing automatically added at a point on the at least one of thetrendlines within the period of time that corresponds to the time atwhich the patient experienced the medically-related event, wherein datadisplayed on at least one of the current value window, the trendswindow, and the assessment window is usable to at least one of diagnose,treat, and assess the patient.
 2. The system of claim 1, wherein theprocessor is configured to allow a user to select which one or more ofthe plurality of physiological parameters to be concurrently displayedin the trends window.
 3. The system of claim 1, wherein the processor isconfigured to cause a detail trends window to be displayed on thedisplay screen in response to a user selecting any one of the trendlinesat the position of the time marker, the detail trends window showing amore detailed version of a portion of the selected trendline for asecond period of time including the selected time, the second period oftime being less than the period of time.
 4. The system of claim 1,wherein the processor is configured to display the assessment windowconcurrently with the trends window on the display screen.
 5. The systemof claim 1, wherein the processor is configured to only display theassessment window concurrently with the trends window on the displayscreen in response to a user input to the processor.
 6. The system ofclaim 1, wherein the processor is configured to concurrently displayeach of the plurality of windows on the display screen.
 7. The system ofclaim 1, wherein the processor is configured to display a selected oneor more of the plurality of windows at a time, the displayed one or morewindows being user selected from among the plurality of windows.
 8. Thesystem of claim 1, wherein the processor is configured to allow a userto repeatedly change a length of the period of time.
 9. The system ofclaim 1, wherein the plurality of windows also includes a future windowthat displays projected future values for each of the physiologicalparameters values beyond the time period, the processor being configuredto calculate the projected future values based on the measured values.10. The system of claim 1, wherein the plurality of physiologicalparameters comprises at least two of intracranial pressure (ICP),cerebral perfusion pressure (CPP), mean arterial blood pressure (MAP),oxygen saturation (pO₂), heart rate, and temperature.
 11. The system ofclaim 1, wherein the processor receives the plurality of values for eachof the plurality of physiological parameters from at least one sensorattached to the patient.
 12. The system of claim 1, wherein the timemarker includes a mark crossing each of the trendlines.
 13. The systemof claim 1, wherein the at least one notification marker uniquelyvisually identifies a type of the medically-related event.
 14. Thesystem of claim 1, wherein the at least one notification marker isconfigured to facilitate user evaluation of the one or morephysiological parameters associated with the at least one of thetrendlines at the time at which the patient experienced themedically-related event.
 15. The system of claim 1, wherein themedically-related event is at least one of an action performed bymedical personnel, the patient being moved within a care facility, thepatient having a visitor, the patient sleeping, the patient being awake,the patient eating, the patient experiencing a planned medical event,and the patient experiencing an unplanned medical event.
 16. A method ofdisplaying medical information relating to a patient, comprising:receiving a plurality of values for each of a plurality of physiologicalparameters measured from a patient over a period of time; displaying aplurality of windows on a display screen, the plurality of windowscomprising: a current value window that shows a current value for eachof the plurality of physiological parameters, and a trends window thatshows a trendline for each of the plurality of physiological parameters,each of the trendlines indicating for its associated physiologicalparameter the values of the physiological parameter over the period oftime; receiving an input representing a user-selected time; displaying atime marker on the trends window, a position of the time marker relativeto each of the trendlines indicating the user-selected time within theperiod of time, wherein the marker is movable simultaneously along eachof the trendlines; displaying an assessment window on the display screenthat indicates a value of each of the plurality of physiologicalparameters at the user-selected time; receive a notification identifyinga medically-related event experienced by the patient at a time withinthe period of time, the medically-related event being an event thataffects at least one of the plurality of physiological parameters; andautomatically displaying at least one notification marker on at leastone of the trendlines in response to the receipt of the notification,the at least one notification marker being disposed at a point on the atleast one of the trendlines within the period of time that correspondsto the time at which the patient experienced the medically-relatedevent, wherein data displayed on at least one of the current valuewindow, the trends window, and the assessment window is usable to atleast one of diagnose, treat, and assess the patient.
 17. The method ofclaim 16, wherein the plurality of physiological parameters comprises atleast two of intracranial pressure (ICP), cerebral perfusion pressure(CPP), mean arterial blood pressure (MAP), oxygen saturation (pO₂),heart rate, and temperature.
 18. A tangible computer readable mediumhaving stored thereon a program, that when executed, performs the methodof claim
 16. 19. The method of claim 16, wherein receiving the pluralityof values for each of the plurality of physiological parameters includesreceiving data from at least one sensor attached to the patient.
 20. Themethod of claim 16, wherein the at least one notification markerincludes a plurality of notification markers, and each of the pluralityof notification markers is displayed on a different one of thetrendlines such that each of the trendlines has a different number ofnotification markers displayed thereon.